Dear Editor:
I read with interest the various articles published in the past 12 months focusing on colorectal cancer (CRC) screening [1, 2]. The authors identified various social, economical and even familial barriers towards adoption of screening. But perhaps, the awareness of the risks of developing CRC is equally important as well to drive human behaviours.
It is well known that the some of the well-established risk factors in the pathogenesis of CRC included unhealthy lifestyles and dietary habits [3, 4]. As a result, the World Health Organization also recently recommended that processed meat be classified as a carcinogen in the development of CRC [5]. And with the majority of the colorectal cancer patients being in their late 60s to early 80s, it would be sensible to assume that part of their lifestyle and dietary habits would be shared by their spouses/partners, who are typically married or being together since their 20s or 30s.
Most of the attention on the spouses of CRC has been on the psychological and social aspects of taking care of a patient with CRC. The notion of spouses of CRC in the modern era being at increased risk of developing CRC is poorly explored. Over the past 3 years, our colorectal surgery unit, which managed between 250 and 300 CRC per year, has actually managed 5 couples with concurrent colorectal cancer or advanced adenoma. The youngest couple aged in their 50s had locally advanced rectal cancers, while another couple in their 70s had very early sigmoid cancer. There was one couple where the husband had stage IV sigmoid colon cancer while the wife had an advanced sigmoid colon adenoma. Two other couples in their 60s and 70s also had concurrent CRCs. It is also uncertain how many more spouses of CRC could be harbouring CRC or polyps as they have not undergone colonoscopy.
We hope that by bringing up our observation, more work can be done in the community to ascertain if spouses of colorectal cancer patients do possess a higher risk of developing colonic adenoma and colorectal cancer. This could have huge implications in the formulation of screening guidelines and counselling of spouses of CRC patients going ahead.
References
Deding U, Henig AS, Salling A, Torp-Pedersen C, Bøggild H (2017) Sociodemographic predictors of participation in colorectal cancer screening. Int J Color Dis 32(8):1117–1124. https://doi.org/10.1007/s00384-017-2832-6
Tan KK, Lim TZ, Chan DKH, Chew E, Chow WM, Luo N, Wong ML, Koh GC (2017) Getting the first degree relatives to screen for colorectal cancer is harder than it seems-patients’ and their first degree relatives’ perspectives. Int J Color Dis 32(7):1065–1068. https://doi.org/10.1007/s00384-017-2818-4
Aune D, Chan DS, Vieira AR, Navarro Rosenblatt DA, Vieira R, Greenwood DC, Kampman E, Norat T (2013) Red and processed meat intake and risk of colorectal adenomas: a systematic review and meta-analysis of epidemiological studies. Cancer Causes Control 24(4):611–627. https://doi.org/10.1007/s10552-012-0139-z
Sandler RS (1996) Epidemiology and risk factors for colorectal cancer. Gastroenterol Clin N Am 25(4):717–735
Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, Guha N, Mattock H, Straif K, International Agency for Research on Cancer Monograph Working Group (2015) Carcinogenicity of consumption of red and processed meat. Lancet Oncol 16(16):1599–1600
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Tan, KK., Koh, G.C.H. Could spouses of colorectal cancer patients possess higher risk of developing colorectal cancer?. Int J Colorectal Dis 33, 353 (2018). https://doi.org/10.1007/s00384-018-2966-1
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DOI: https://doi.org/10.1007/s00384-018-2966-1