![]() ![]() We conducted a nationwide cohort study including 5,099,172 Swedish women born after 1931. As there is a need for an earlier screening in women at increased risk of breast cancer, we provided evidence-based risk-adapted starting age of screening based on different reproductive profiles. The implementation of a unified management plan for familial cancers at large will be a major challenge to the clinical genetic counselling community.Īlthough reproductive history is recognised to affect the risk of breast cancer, current breast cancer screening guidelines do not consider risk differences by this important factor. ![]() Reliable risk estimates for other cancers should also be seriously considered for routine clinical recommendations, because practically all cancers show a familial effect and the risks are high for some of the rare neoplasms. Useful risk estimates have been developed for familial breast and prostate cancers. Epidemiological studies can be used to generate clinical estimates for familial risk, conditioned on numbers of affected family members and their ages of onset. Colon and rectal cancers appeared to be distinguished between high-penetrant and recessive conditions that only affect the colon, whereas low-penetrant familial effects are shared by the two sites. Thus the familial excess (SIR-1.00) was more than two fold higher for right-sided colon cancer. The SIRs for colon cancer in age matched populations were 2.58 when parents were probands and 3.81 when siblings were probands for right-sided colon cancer the SIRs were 3.66 and 7.53, respectively. The excess risk was limited to colon cancer and particularly to right-sided colon cancer. ![]() ![]() As a novel finding it was shown that risks for siblings were higher than those for offspring of affected parents. Familial standardized incidence ratios (SIRs) were determined for offspring when parents or sibling were diagnosed with colon or rectal cancer. We show one application of the Database in the study of familial risks in colorectal adenocarcinoma, with defined age-group and anatomic site specific analyses. Compared to previous versions, only 6.0% of deceased offspring with a cancer diagnosis lack any parental information. Cancer cases were retrieved from the Swedish Cancer Registry from 1958-2002, including over 1.2 million first and multiple primary cancers and in situ tumours. This update included all Swedes born in 1932 and later (offspring) with their biological parents, a total of 10.5 million individuals. In the present paper we describe some main features of version VI of this Database, assembled in 2004. The Swedish Family-Cancer Database has been used for almost 10 years in the study of familial risks at all common sites. ![]()
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