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Associations between pathological features and risk of metachronous colorectal cancer

医学 林奇综合征 结直肠癌 穆提 内科学 危险系数 肿瘤科 入射(几何) 癌症 人口 癌症登记处 比例危险模型 置信区间 种系突变 DNA错配修复 突变 物理 光学 基因 环境卫生 化学 生物化学
作者
Y. Zhang,Aung Ko Win,Enes Makalic,Daniel D. Buchanan,Rish K. Pai,Amanda I. Phipps,Christophe Rosty,Alex Boussioutas,Amalia Karahalios,Mark A. Jenkins
出处
期刊:International Journal of Cancer [Wiley]
标识
DOI:10.1002/ijc.34979
摘要

Abstract Survivors of colorectal cancer (CRC) are at risk of developing another primary colorectal cancer ‐ metachronous CRC. Understanding which pathological features of the first tumour are associated with risk of metachronous CRC might help tailor existing surveillance guidelines. Population‐based CRC cases were recruited from the United States, Canada and Australia between 1997 and 2012 and followed prospectively until 2022 by the Colon Cancer Family Registry. Metachronous CRC was defined as a new primary CRC diagnosed at least 1 year after the initial CRC. Those with the genetic cancer predisposition Lynch syndrome or MUTYH mutation carriers were excluded. Cox regression models were fitted to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the associations. Of 6085 CRC cases, 138 (2.3%) were diagnosed with a metachronous CRC over a median follow‐up time of 12 years (incidence: 2.0 per 1000 person‐years). CRC cases with a synchronous CRC were 3.4‐fold more likely to develop a metachronous CRC (adjusted HR: 3.36, 95% CI: 1.89–5.98) than those without a synchronous tumour. CRC cases with MMR‐deficient tumours had a 72% increased risk of metachronous CRC (adjusted HR: 1.72, 95% CI: 1.11–2.64) compared to those with MMR‐proficient tumours. Compared to cases who had an adenocarcinoma histologic type, those with an undifferentiated histologic type were 77% less likely to develop a metachronous CRC (adjusted HR: 0.23, 95% CI: 0.06–0.94). Existing surveillance guidelines for CRC survivors could be updated to include increased surveillance for those whose first CRC was diagnosed with a synchronous CRC or was MMR‐deficient.
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