Impact of Family History on Prognosis of Patients with Sporadic Colorectal Cancer

  • Soo Young Lee
  • Duck-Woo KimEmail author
  • Sung Il Kang
  • Myong Hoon Ihn
  • Heung-Kwon Oh
  • Sung-Bum Kang
  • Chang Hyun Kim
  • Hyeong Rok Kim
  • Young Jin Kim
  • Jae Kyun Ju
Colorectal Cancer



A family history (FH) of colorectal cancer (CRC) increases the risk for development of CRC, but the impact of FH of CRC on survival from sporadic CRC is unclear. This study investigated the prognostic impact of FH of CRC on the recurrence and survival of patients with sporadic CRC.


We reviewed the records of patients with sporadic CRC from two tertiary referral hospitals in Korea who underwent surgical resection between May 2007 and September 2013. The clinicopathologic features and oncologic outcomes of those with and without FHs of CRC were compared.


We examined the records of 2960 eligible patients, 163 (5.5%) of whom had first-degree relatives with CRC. Patients with and without FHs of CRC had similar baseline characteristics. Multivariable analysis indicated that a FH of CRC was not significantly associated with disease-free survival but was significantly associated with better overall survival (OS) [adjusted hazard ratio = 0.539, 95% confidence interval (CI) 0.330–0.881, P = 0.014]. Subgroup analysis indicated that females and rectal cancer patients with FHs of CRC had significantly better prognoses. Microsatellite status did not affect the improved survival rate associated with FH.


This study of patients with sporadic CRC indicated that those who had FHs of CRC had better OS but similar cancer recurrence as those who had no FH of CRC. The effect of FH of CRC on OS was independent of microsatellite status. Further studies are needed to identify underlying mechanisms and determine the optimal clinical management of CRC according to FH.



This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant Number NRF-2017R1A2B4012238).


The authors declare no conflicts of interest.

Supplementary material

10434_2019_7179_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)
10434_2019_7179_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 15 kb)


  1. 1.
    Silva FC, Wernhoff P, Dominguez-Barrera C, Dominguez-Valentin M. Update on hereditary colorectal cancer. Anticancer Res. 2016;36(9):4399–405.CrossRefGoogle Scholar
  2. 2.
    Giardiello FM, Allen JI, Axilbund JE, et al. Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-society Task Force on colorectal cancer. Am J Gastroenterol. 2014;109(8):1159–79.CrossRefGoogle Scholar
  3. 3.
    Boland CR, Goel A. Microsatellite instability in colorectal cancer. Gastroenterology. 2010;138(6):2073–87 e3.Google Scholar
  4. 4.
    Lee SY, Kim DW, Lee HS, et al. Low-level microsatellite instability as a potential prognostic factor in sporadic colorectal cancer. Medicine (Baltimore). 2015;94(50):e2260.CrossRefGoogle Scholar
  5. 5.
    Chan JA, Meyerhardt JA, Niedzwiecki D, et al. Association of family history with cancer recurrence and survival among patients with stage III colon cancer. JAMA. 2008;299(21):2515–23.CrossRefGoogle Scholar
  6. 6.
    Zell JA, Honda J, Ziogas A, Anton-Culver H. Survival after colorectal cancer diagnosis is associated with colorectal cancer family history. Cancer Epidemiol Biomarkers Prev. 2008;17(11):3134–40.CrossRefGoogle Scholar
  7. 7.
    Birgisson H, Ghanipour A, Smedh K, Pahlman L, Glimelius B. The correlation between a family history of colorectal cancer and survival of patients with colorectal cancer. Fam Cancer. 2009;8(4):555–61.CrossRefGoogle Scholar
  8. 8.
    Kao PS, Lin JK, Wang HS, et al. The impact of family history on the outcome of patients with colorectal cancer in a veterans’ hospital. Int J Colorectal Dis. 2009;24(11):1249–54.CrossRefGoogle Scholar
  9. 9.
    Lee SD, Kim BC, Han KS, et al. Influence of family history on survival in patients with colon and rectal cancer. J Dig Dis. 2014;15(3):108–15.CrossRefGoogle Scholar
  10. 10.
    Kirchhoff AC, Newcomb PA, Trentham-Dietz A, Nichols HB, Hampton JM. Family history and colorectal cancer survival in women. Fam Cancer. 2008;7(4):287–92.CrossRefGoogle Scholar
  11. 11.
    Phipps AI, Ahnen DJ, Campbell PT, et al. Family history of colorectal cancer is not associated with colorectal cancer survival regardless of microsatellite instability status. Cancer Epidemiol Biomarkers Prev. 2014;23(8):1700–4.CrossRefGoogle Scholar
  12. 12.
    Slattery ML, Kerber RA. The impact of family history of colon cancer on survival after diagnosis with colon cancer. Int J Epidemiol. 1995;24(5):888–96.CrossRefGoogle Scholar
  13. 13.
    Bass AJ, Meyerhardt JA, Chan JA, Giovannucci EL, Fuchs CS. Family history and survival after colorectal cancer diagnosis. Cancer. 2008;112(6):1222–9.CrossRefGoogle Scholar
  14. 14.
    Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15(7):767–74.CrossRefGoogle Scholar
  15. 15.
    Kim CH, Huh JW, Kim HR, Kim YJ. Prognostic comparison between number and distribution of lymph node metastases in patients with right-sided colon cancer. Ann Surg Oncol. 2014;21(4):1361–8.CrossRefGoogle Scholar
  16. 16.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. American Joint Committee on Cancer Staging Manual. 7th ed. New York: Springer; 2009.Google Scholar
  17. 17.
    National Comprehensive Cancer Network. Clinical practice guidelines in oncology—genetic/familial high-risk assessment: Colorectal. Accessed 1 Mar 2018.Google Scholar
  18. 18.
    National Comprehensive Cancer Network. Colon cancer clinical practice guidelines in oncology. Available at: Accessed 1 Mar 2018.
  19. 19.
    National Comprehensive Cancer Network. Rectal cancer clinical practice guidelines in oncology. Available at: Accessed 1 Mar 2018.
  20. 20.
    Sterne JA, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393.CrossRefGoogle Scholar
  21. 21.
    Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Speizer FE, Willett WC. A prospective study of family history and the risk of colorectal cancer. N Engl J Med. 1994;331(25):1669–74.CrossRefGoogle Scholar
  22. 22.
    Johns LE, Houlston RS. A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol. 2001;96(10):2992–3003.CrossRefGoogle Scholar
  23. 23.
    Butterworth AS, Higgins JP, Pharoah P. Relative and absolute risk of colorectal cancer for individuals with a family history: a meta-analysis. Eur J Cancer. 2006;42(2):216–27.CrossRefGoogle Scholar
  24. 24.
    Imperiale TF, Ransohoff DF. Risk for colorectal cancer in persons with a family history of adenomatous polyps: a systematic review. Ann Intern Med. 2012;156(10):703–9.CrossRefGoogle Scholar
  25. 25.
    Schoen RE, Razzak A, Yu KJ, et al. Incidence and Mortality of Colorectal Cancer in Individuals With a Family History of Colorectal Cancer. Gastroenterology. 2015;149(6):1438–45 e1.Google Scholar
  26. 26.
    Duffy SW, Nagtegaal ID, Wallis M, et al. Correcting for lead time and length bias in estimating the effect of screen detection on cancer survival. Am J Epidemiol. 2008;168(1):98–104.CrossRefGoogle Scholar
  27. 27.
    Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15(6):621–30.CrossRefGoogle Scholar
  28. 28.
    Patterson F, Wileyto EP, Segal J, Kurz J, Glanz K, Hanlon A. Intention to quit smoking: role of personal and family member cancer diagnosis. Health Educ Res. 2010;25(5):792–802.CrossRefGoogle Scholar
  29. 29.
    Hardikar S, Newcomb PA, Campbell PT, et al. Prediagnostic physical activity and colorectal cancer survival: overall and stratified by tumor characteristics. Cancer Epidemiol Biomarkers Prev. 2015;24(7):1130–7.CrossRefGoogle Scholar
  30. 30.
    McCleary NJ, Niedzwiecki D, Hollis D, et al. Impact of smoking on patients with stage III colon cancer: results from Cancer and Leukemia Group B 89803. Cancer. 2010;116(4):957–66.CrossRefGoogle Scholar
  31. 31.
    Phipps AI, Baron J, Newcomb PA. Prediagnostic smoking history, alcohol consumption, and colorectal cancer survival: the Seattle Colon Cancer Family Registry. Cancer. 2011;117(21):4948–57.CrossRefGoogle Scholar
  32. 32.
    Gryfe R, Kim H, Hsieh ET, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer. N Engl J Med. 2000;342(2):69–77.CrossRefGoogle Scholar
  33. 33.
    Parc Y, Gueroult S, Mourra N, et al. Prognostic significance of microsatellite instability determined by immunohistochemical staining of MSH2 and MLH1 in sporadic T3N0M0 colon cancer. Gut. 2004;53(3):371–5.CrossRefGoogle Scholar
  34. 34.
    Fiederling J, Shams AZ, Haug U. Validity of self-reported family history of cancer: a systematic literature review on selected cancers. Int J Cancer. 2016;139(7):1449–60.CrossRefGoogle Scholar
  35. 35.
    Murff HJ, Spigel DR, Syngal S. Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA. 2004;292(12):1480–9.CrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Soo Young Lee
    • 1
  • Duck-Woo Kim
    • 2
    • 3
    Email author
  • Sung Il Kang
    • 2
  • Myong Hoon Ihn
    • 4
  • Heung-Kwon Oh
    • 2
  • Sung-Bum Kang
    • 2
  • Chang Hyun Kim
    • 1
  • Hyeong Rok Kim
    • 1
  • Young Jin Kim
    • 1
  • Jae Kyun Ju
    • 5
  1. 1.Department of SurgeryChonnam National University Hwasun Hospital and Medical SchoolHwasunKorea
  2. 2.Department of SurgerySeoul National University Bundang HospitalSeongnamKorea
  3. 3.Korean Hereditary Tumor RegistrySeoul National University College of MedicineSeoulKorea
  4. 4.Department of SurgerySoonchunhyang University Gumi HospitalGumiKorea
  5. 5.Department of SurgeryChonnam National University Hospital and Medical SchoolGwangjuKorea

Personalised recommendations