A recent study by Dr. Rubin from the University of Chicago evaluated over 180,000 patients with urological cancers such as renal pelvis and ureteral cancers and over 350,000 with colorectal cancer.
It is known that families with a genetic predisposition to colon cancer known as HNPCC (hereditary colorectal cancers) are at higher risk to develop additional cancers such as upper gastrointestinal cancers, ovarian and endometrium cancers but also renal cancers. This is one of the first and largest studies to connect colorectal and urological cancers.
The numbers are quite impressive. For example, for patients with colorectal cancer the risk for urological cancers was increased by 24%. For patients with ureteral cancers, an 80% increase risk of subsequent colorectal cancers were seen. Patients with renal pelvis cancer had a 44% increased risk of colorectal cancers. Patients with bladder cancers also had a small increase.
These data have implications for how patients with colorectal and urological cancers are followed up. We need to make sure that patients with either disease are screened for their increased risk of the other cancers (including getting colonoscopies).
These data were published in the May issue of Archives of Internal Medicine. In Dr. Rubin’s data set patients with multiple primary colon cancers had significantly increased risk for renal pelvis cancer.
It is difficult to understand why questions like how does smoking, family history, screening bias lead to these data. I also find it interesting that the patients diagnosed between 50 and 60 had increased the risk for the other cancers.