Women with Colorectal and Endometrial Cancer

Characteristics of women who develop both colorectal and endometrial cancer.

P. T. Soliman, B. M. Slomovitz, C. C. Sun, D. M. Gershenson, K. H. Lu;

University of Texas, M. D. Anderson Cancer Center, Houston, TX

Abstract: Background: Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant syndrome that confers a 60-80% lifetime risk of developing colorectal cancer and a 40-60% lifetime risk of developing endometrial cancer.

Large population-based studies have shown that women with colon cancer who do not meet Amsterdam criteria for HNPCC but have a first-degree relative with colon cancer also have a significant increased relative risk (RR 9.4) for developing endometrial cancer.

The purpose of this study was to evaluate the characteristics of patients with both colorectal and endometrial cancer in order to identify subgroups who may benefit from early cancer screening.

Methods: Between 1985-2002, 77 patients with both colorectal and endometrial cancer were identified. Clinical and pathologic information was obtained from medical records.

Patients were divided into three groups: AC+ (met Amsterdam criteria for HNPCC), AC-R (family history of at least one HNPCC-related cancer), and AC- (no family history of HNPCC-related cancers).

Results: Eight patients were assigned to the AC+ group, 27 patients to the AC-R group, and 41 patients to the AC- group. The mean age at diagnosis of the first cancer for each group was 44, 58, and 58 years.

The median interval of time between the two cancer diagnoses was 4.7, 3.0, and 8.1 years for each group. Sixteen percent of patients (12/77) developed both colorectal and endometrial cancer within one year.

Forty-eight percent of patients (37/77) had colorectal cancer and 36% (28/77) had endometrial cancer as their initial cancer diagnosis.

Conclusions: In this cohort of women with both colorectal and endometrial cancer, only 10% met Amsterdam criteria for HNPCC.

Thirty-five percent did not meet Amsterdam criteria but had at least one relative with an HNPCC-related cancer. In this group (AC-R), 63% of patients developed their second cancer within 5 years of their initial cancer diagnosis.

On-going studies are being performed to identify whether molecular markers in combination with family history can be used to identify women at risk for developing second cancers.

Abstract No: 5052

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