Laura Koskenvuo1, Janne Pitkäniemi, Matti Rantanen, Anna Lepistö. 1. *Department of Colorectal Surgery, Abdominal Center, Helsinki University Hospital †Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research ‡Department of Public Health, University of Helsinki, Helsinki, Finland.
Abstract
GOALS: Our aim was to determine whether the screening of family members of familial adenomatous polyposis (FAP) patients significantly influences survival, and to gauge the extent of FAP-related causes of death. BACKGROUND: The screening of families with FAP has been shown to be profitable in reducing colorectal cancer-related mortality, but conclusions about the screening effect on overall survival has been controversial. STUDY: This is a nationwide population-based retrospective cohort study, and the primary outcome of interest was overall mortality and survival. A total of 154 families with at least 1 clinically diagnosed FAP patient between 1963 and 2015 were included. There were altogether 194 probands and 225 call-ups. During the follow-up period, 2639 person-years with 92 deaths among probands were observed and 3634 person-years and 30 deaths among call-ups. We report crude mortality rates and standardized mortality ratios together with descriptive statistics. We compared the survival of probands and call-ups to the population by relative survival method. RESULTS: The crude mortality rate among probands was 34.9 per 1000 person-years and 8.3 among call-ups. The standardized mortality ratios for call-ups was 2.47 (confidence interval, 1.69-3.46) and for probands 4.07 (confidence interval, 3.29-4.96) (P=0.014). The relative survival of probands was significantly lower than call-ups (P=0.0018), and 20-year relative survival for call-ups was 94% (88% to 100%). Over two thirds of all deaths were FAP related. CONCLUSIONS: Survival of screened family members of FAP patients is comparable to the general population within 20 years after diagnosis. Therefore, participation in surveillance should not be delayed when a family member with FAP has been detected.
GOALS: Our aim was to determine whether the screening of family members of familial adenomatous polyposis (FAP) patients significantly influences survival, and to gauge the extent of FAP-related causes of death. BACKGROUND: The screening of families with FAP has been shown to be profitable in reducing colorectal cancer-related mortality, but conclusions about the screening effect on overall survival has been controversial. STUDY: This is a nationwide population-based retrospective cohort study, and the primary outcome of interest was overall mortality and survival. A total of 154 families with at least 1 clinically diagnosed FAPpatient between 1963 and 2015 were included. There were altogether 194 probands and 225 call-ups. During the follow-up period, 2639 person-years with 92 deaths among probands were observed and 3634 person-years and 30 deaths among call-ups. We report crude mortality rates and standardized mortality ratios together with descriptive statistics. We compared the survival of probands and call-ups to the population by relative survival method. RESULTS: The crude mortality rate among probands was 34.9 per 1000 person-years and 8.3 among call-ups. The standardized mortality ratios for call-ups was 2.47 (confidence interval, 1.69-3.46) and for probands 4.07 (confidence interval, 3.29-4.96) (P=0.014). The relative survival of probands was significantly lower than call-ups (P=0.0018), and 20-year relative survival for call-ups was 94% (88% to 100%). Over two thirds of all deaths were FAP related. CONCLUSIONS: Survival of screened family members of FAPpatients is comparable to the general population within 20 years after diagnosis. Therefore, participation in surveillance should not be delayed when a family member with FAP has been detected.
Authors: Adam P Yan; Yan Chen; Tara O Henderson; Kevin C Oeffinger; Melissa M Hudson; Todd M Gibson; Joseph P Neglia; Wendy M Leisenring; Kirsten K Ness; Jennifer S Ford; Leslie L Robison; Gregory T Armstrong; Yutaka Yasui; Paul C Nathan Journal: J Clin Oncol Date: 2020-03-06 Impact factor: 44.544
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Authors: Gaia Colletti; Chiara Maura Ciniselli; Stefano Signoroni; Ivana Maria Francesca Cocco; Andrea Magarotto; Maria Teresa Ricci; Clorinda Brignola; Clara Bagatin; Laura Cattaneo; Andrea Mancini; Federica Cavalcoli; Massimo Milione; Paolo Verderio; Marco Vitellaro Journal: Cancers (Basel) Date: 2022-01-08 Impact factor: 6.639