AIM To quantify the risk of gastric cancer in first-degree relatives of patients with the cancer. METHODS A comprehensive literature search was performed. Case-control trials comparing the frequency of a positive fami...AIM To quantify the risk of gastric cancer in first-degree relatives of patients with the cancer. METHODS A comprehensive literature search was performed. Case-control trials comparing the frequency of a positive family history of gastric cancer in patients with gastric cancer, vs non-gastric cancer controls were retrieved. Studies with missed or non-extractable data, studies in children, abstracts, and duplicate publications were excluded. A meta-analysis of pooled odd ratios was performed using Review Manager 5.0.25. We performed subgroup analysis on Asian studies and a sensitivity analysis based on the quality of the studies, type of the outcome, sample size, and whether studies considered only first-degree relatives. RESULTS Thirty-two relevant studies out of 612 potential abstracts(n = 80690 individuals) were included. 19.0% of the patients and 10.9% of the controls had at least one relative with gastric cancer(P < 0.00001). The pooled relative risk for the development of gastric cancer in association with a positive family history was 2.35(95%CI: 1.96-2.81). The Cochran Q test for heterogeneity was positive(P < 0.00001, I 2 = 92%). After excluding the three outlier studies with the highest relative risks, heterogeneity remained significant(P < 0.00001, I 2 = 90%). The result was not different among Asian studies as compared to others and remained robust in several sensitivity analyses. In the 26 studies which exclusively analysed the history of gastric cancer in first-degree relatives, the relative risk was 2.71(95%CI: 2.08-3.53; P < 0.00001). CONCLUSION Individuals with a first-degree relative affected with gastric cancer have a risk of about 2.5-fold for the development of gastric cancer. This could be due to genetic or environmental factors. Screening and preventive strategies should be developed for this highrisk population.展开更多
BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore...BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore studies are lacking to validate non-invasive screening methods in individuals with positive family history.AIM To quantify the risk of colorectal cancer in individuals with a positive family history.METHODS A comprehensive electronic literature search was performed using PubMed from January 1955 until November 2017,EMBASE from 1947 until 2018,and Cochrane Library without date restrictions.Two independent reviewers conducted study selection,data extraction and quality assessment.A meta-analysis of Mantel-Haenzel relative risks was performed using the random effects model.Newcastle-Ottawa scale was used to score the quality of selected papers.Funnel plot and Egger’s regression test was performed to detect publication bias.Subgroup analysis was performed comparing Asian and non-Asian studies.Sensitivity analyses were performed to rule out the effect of the timing of the study,overall quality,the main outcome and the effect of each individual study in overall result.RESULTS Forty-six out of 3390 studies,including 906981 patients were included in the final analysis.41 of the included studies were case-control and 5 were cohort.A positive family history of colorectal cancer in first-degree relatives was associated with significantly increased risk of colorectal cancer with a relative risk of 1.87(95%CI:1.68-2.09;P<0.00001).Cochrane Q test was significant(P<0.00001,I2=90%).Egger’s regression test showed asymmetry in the funnel plot and therefore the Trim and Fill method was used which confirmed the validity of the results.There was no difference between Asian versus non-Asian studies.Results remained robust in sensitivity analyses.CONCLUSION Individuals with a positive family history of colorectal cancer are 1.87 times more likely to develop colorectal cancer.Screening guidelines should pay specific attention to individuals with positive family history and further studies need to be done on validating current screening methods or developing new modalities in this high-risk population.展开更多
文摘AIM To quantify the risk of gastric cancer in first-degree relatives of patients with the cancer. METHODS A comprehensive literature search was performed. Case-control trials comparing the frequency of a positive family history of gastric cancer in patients with gastric cancer, vs non-gastric cancer controls were retrieved. Studies with missed or non-extractable data, studies in children, abstracts, and duplicate publications were excluded. A meta-analysis of pooled odd ratios was performed using Review Manager 5.0.25. We performed subgroup analysis on Asian studies and a sensitivity analysis based on the quality of the studies, type of the outcome, sample size, and whether studies considered only first-degree relatives. RESULTS Thirty-two relevant studies out of 612 potential abstracts(n = 80690 individuals) were included. 19.0% of the patients and 10.9% of the controls had at least one relative with gastric cancer(P < 0.00001). The pooled relative risk for the development of gastric cancer in association with a positive family history was 2.35(95%CI: 1.96-2.81). The Cochran Q test for heterogeneity was positive(P < 0.00001, I 2 = 92%). After excluding the three outlier studies with the highest relative risks, heterogeneity remained significant(P < 0.00001, I 2 = 90%). The result was not different among Asian studies as compared to others and remained robust in several sensitivity analyses. In the 26 studies which exclusively analysed the history of gastric cancer in first-degree relatives, the relative risk was 2.71(95%CI: 2.08-3.53; P < 0.00001). CONCLUSION Individuals with a first-degree relative affected with gastric cancer have a risk of about 2.5-fold for the development of gastric cancer. This could be due to genetic or environmental factors. Screening and preventive strategies should be developed for this highrisk population.
文摘BACKGROUND Positive family history is a risk factor for development of colorectal cancer.Despite numerous studies on the topic,the absolute risk in patients with a positive family history remains unclear and therefore studies are lacking to validate non-invasive screening methods in individuals with positive family history.AIM To quantify the risk of colorectal cancer in individuals with a positive family history.METHODS A comprehensive electronic literature search was performed using PubMed from January 1955 until November 2017,EMBASE from 1947 until 2018,and Cochrane Library without date restrictions.Two independent reviewers conducted study selection,data extraction and quality assessment.A meta-analysis of Mantel-Haenzel relative risks was performed using the random effects model.Newcastle-Ottawa scale was used to score the quality of selected papers.Funnel plot and Egger’s regression test was performed to detect publication bias.Subgroup analysis was performed comparing Asian and non-Asian studies.Sensitivity analyses were performed to rule out the effect of the timing of the study,overall quality,the main outcome and the effect of each individual study in overall result.RESULTS Forty-six out of 3390 studies,including 906981 patients were included in the final analysis.41 of the included studies were case-control and 5 were cohort.A positive family history of colorectal cancer in first-degree relatives was associated with significantly increased risk of colorectal cancer with a relative risk of 1.87(95%CI:1.68-2.09;P<0.00001).Cochrane Q test was significant(P<0.00001,I2=90%).Egger’s regression test showed asymmetry in the funnel plot and therefore the Trim and Fill method was used which confirmed the validity of the results.There was no difference between Asian versus non-Asian studies.Results remained robust in sensitivity analyses.CONCLUSION Individuals with a positive family history of colorectal cancer are 1.87 times more likely to develop colorectal cancer.Screening guidelines should pay specific attention to individuals with positive family history and further studies need to be done on validating current screening methods or developing new modalities in this high-risk population.