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Racial Differences in Cancer Risk Among Relatives of Early-onset

¹Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI ²Population Studies and Prevention Program ³Department of Internal Medicine, Karmanos Cancer Institute at Wayne State University School of Medicine, Detroit, MI

cotem{at}med.wayne.edu

Abstract

BackgroundRelatives of early-onset lung cancer patients are at increased risk for developing lung cancer and this risk varies by race. The current study evaluates whether first-degree relatives of early-onset lung cancer cases are at an increased risk of cancer at sites other than lung.

MethodsFamily histories were ascertained from 673 individuals diagnosed with lung cancer prior to 50 years of age, identified from the Metropolitan Detroit Surveillance, Epidemiology and End Results SEER program, and 773 age, race and sex-matched controls were obtained via random digit dialing. Data were collected for 3556 case mothers, fathers, and siblings and 3943 control relatives, and unconditional logistic regression models using generalized estimating equations GEE were used to estimate odds ratios and 95% confidence intervals.

ResultsAmong case relatives, African Americans were 2.44-fold more likely to have head and neck cancers and 1.86-fold more likely to have any tobacco related cancer compared to white case relatives 95% CI 1.04-5.69 and 95% CI 1.25-2.76, respectively. African American case relatives were at increased risk of head and neck cancers OR, 13.42; 95% CI 1.65-109.01, all tobacco related cancers OR, 3.77; 95% CI 2.16-6.55, tobacco related cancers other than lung OR, 4.10; 95% CI 1.56-10.79, and cancer at any site OR, 1.45, 95% CI 1.04-2.02 compared to African American control relatives.

ConclusionsThese results can be used to counsel family members of early-onset lung cancer patients and suggests target populations for preventive strategies, including smoking cessation and appropriate screening.

Key Words: lung cancer • familial aggregation • African Americans • endometrial cancer • tobacco related cancers