Journal Article

Familial Aggregation of Diabetes and Hypertension in a Case-Control Study of Colorectal Neoplasia

Paula M. Brauer, Gail E. McKeown-Eyssen, Vartouhi Jazmaji, Alexander G. Logan, David F. Andrews, David Jenkins, Norman Marcon, Fred Saibil, Lawrence Cohen, Hartley Stern, David Baron, Gordon Greenberg, Eleftherios Diamandis, Gary Kakis, William Singer and George Steiner

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 156, issue 8, pages 702-713
Published in print October 2002 | ISSN: 0002-9262
Published online October 2002 | e-ISSN: 1476-6256 | DOI:
Familial Aggregation of Diabetes and Hypertension in a Case-Control Study of Colorectal Neoplasia

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Familial aggregation of diseases potentially associated with metabolic syndrome (diabetes mellitus, hypertension, and cardiovascular diseases) was assessed in a colonoscopy-based case-control study of colorectal neoplasia in Toronto and Ottawa, Canada, in 1993–1996. Each familial disease was analyzed by logistic regression using generalized estimating equations. Case probands had incident adenomatous polyps (n = 172) or incident (n = 25) or prevalent (n = 132) colorectal cancer (CRC), while control probands (n = 282) had a negative colonoscopy and no history of CRC or polyps. Significant effect modification was evident in the data, with the strongest positive associations between familial diabetes and colorectal neoplasia among older probands with symptoms (parents: odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.2, 4.8; siblings: OR = 5.8, 95% CI: 2.6, 13.3). Familial hypertension was also associated with colorectal neoplasia among probands with symptoms (OR = 1.7, 95% CI: 1.1, 2.6). In stratified analyses, familial diabetes, hypertension, and stroke were positively associated with adenomatous polyps in subgroups of probands who were older and/or had symptoms, while only familial diabetes was possibly associated with CRC. Associations in other proband groups may have been obscured by high cumulative incidence of parental CRC. Family studies are needed to understand the contribution of specific environmental and genetic factors in accounting for the disease aggregations.

Keywords: adenomatous polyps; case-control studies; colorectal neoplasms; diabetes mellitus; family; family health; hypertension; insulin resistance; Abbreviations: BMI, body mass index; CI, confidence interval; CRC, colorectal cancer; FHQ, family history questionnaire; OR, odds ratio.

Journal Article.  8082 words.  Illustrated.

Subjects: Public Health and Epidemiology

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