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Risk of colorectal cancer associated with frequency of colorectal polyp diagnosis in relatives

Hu, Yuqing LU ; Kharazmi, Elham LU ; Liang, Qunfeng LU ; Sundquist, Kristina LU ; Sundquist, Jan LU and Fallah, Mahdi LU orcid (2025) In Gastroenterology
Abstract

BACKGROUND & AIMS: We aimed to evaluate the association of frequency of polyp diagnosis in relatives with the risk of overall and early-onset colorectal cancer (CRC).

METHODS: We leveraged data from nationwide Swedish family cancer datasets (1964-2018) to calculate standardized incidence ratios (SIRs) for individuals with a family history of polyp by frequency of polyp diagnosis in family members.

RESULTS: We followed up 11,676,043 individuals for up to 54 years. Compared with the risk in individuals without a family history of colorectal tumor (N=142,234), the risk of overall CRC was 1.4-fold in those with 1 FDR with one-time polyp diagnosis [95%CI=1.3-1.4, N=11,035; early-onset SIR: 1.4 (1.3-1.5), N=742]. The risk was... (More)

BACKGROUND & AIMS: We aimed to evaluate the association of frequency of polyp diagnosis in relatives with the risk of overall and early-onset colorectal cancer (CRC).

METHODS: We leveraged data from nationwide Swedish family cancer datasets (1964-2018) to calculate standardized incidence ratios (SIRs) for individuals with a family history of polyp by frequency of polyp diagnosis in family members.

RESULTS: We followed up 11,676,043 individuals for up to 54 years. Compared with the risk in individuals without a family history of colorectal tumor (N=142,234), the risk of overall CRC was 1.4-fold in those with 1 FDR with one-time polyp diagnosis [95%CI=1.3-1.4, N=11,035; early-onset SIR: 1.4 (1.3-1.5), N=742]. The risk was significantly higher in individuals with 1 FDR with ≥2 times (frequent) polyp diagnoses [overall CRC: 1.8 (1.8-1.9); early-onset CRC=2.3 (2.0-2.6)]. A rather similar risk was observed for individuals with ≥2 FDRs with one-time polyp diagnosis [overall CRC: 1.9 (1.7-2.1); early-onset CRC: 2.2 (1.5-2.9)]. Individuals with ≥2 FDRs with frequent polyp diagnoses had a 2.4-fold overall risk (2.2-2.7) and a 3.9-fold early-onset risk (2.8-5.3). Younger age at polyp diagnosis in FDRs was associated with an increased risk of CRC. A family history of polyp in second-degree relatives was important only when there were frequent diagnoses of polyp.

CONCLUSIONS: A higher frequency of colorectal polyp diagnosis in relatives is associated with a greater risk of CRC, especially early-onset CRC. This risk is independent of number of affected relatives or youngest age at polyp diagnosis. These findings underscore the need for more personalized CRC screening strategies that are tailored to individuals with a family history of polyp.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Gastroenterology
publisher
Elsevier
external identifiers
  • scopus:105001040461
  • pmid:39800079
ISSN
1528-0012
DOI
10.1053/j.gastro.2024.12.030
language
English
LU publication?
yes
additional info
Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.
id
ff5c726e-16e8-4a3e-8880-55004110f8af
date added to LUP
2025-01-13 11:01:15
date last changed
2025-07-22 11:45:31
@article{ff5c726e-16e8-4a3e-8880-55004110f8af,
  abstract     = {{<p>BACKGROUND &amp; AIMS: We aimed to evaluate the association of frequency of polyp diagnosis in relatives with the risk of overall and early-onset colorectal cancer (CRC).</p><p>METHODS: We leveraged data from nationwide Swedish family cancer datasets (1964-2018) to calculate standardized incidence ratios (SIRs) for individuals with a family history of polyp by frequency of polyp diagnosis in family members.</p><p>RESULTS: We followed up 11,676,043 individuals for up to 54 years. Compared with the risk in individuals without a family history of colorectal tumor (N=142,234), the risk of overall CRC was 1.4-fold in those with 1 FDR with one-time polyp diagnosis [95%CI=1.3-1.4, N=11,035; early-onset SIR: 1.4 (1.3-1.5), N=742]. The risk was significantly higher in individuals with 1 FDR with ≥2 times (frequent) polyp diagnoses [overall CRC: 1.8 (1.8-1.9); early-onset CRC=2.3 (2.0-2.6)]. A rather similar risk was observed for individuals with ≥2 FDRs with one-time polyp diagnosis [overall CRC: 1.9 (1.7-2.1); early-onset CRC: 2.2 (1.5-2.9)]. Individuals with ≥2 FDRs with frequent polyp diagnoses had a 2.4-fold overall risk (2.2-2.7) and a 3.9-fold early-onset risk (2.8-5.3). Younger age at polyp diagnosis in FDRs was associated with an increased risk of CRC. A family history of polyp in second-degree relatives was important only when there were frequent diagnoses of polyp.</p><p>CONCLUSIONS: A higher frequency of colorectal polyp diagnosis in relatives is associated with a greater risk of CRC, especially early-onset CRC. This risk is independent of number of affected relatives or youngest age at polyp diagnosis. These findings underscore the need for more personalized CRC screening strategies that are tailored to individuals with a family history of polyp.</p>}},
  author       = {{Hu, Yuqing and Kharazmi, Elham and Liang, Qunfeng and Sundquist, Kristina and Sundquist, Jan and Fallah, Mahdi}},
  issn         = {{1528-0012}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{Elsevier}},
  series       = {{Gastroenterology}},
  title        = {{Risk of colorectal cancer associated with frequency of colorectal polyp diagnosis in relatives}},
  url          = {{http://dx.doi.org/10.1053/j.gastro.2024.12.030}},
  doi          = {{10.1053/j.gastro.2024.12.030}},
  year         = {{2025}},
}