Significance of family anamnesis in cervix carcinoma

Abstract

Except for certain types of familiar cancer, the impact and contribution of familial factors to the development of sporadic cancer is thought to be relatively minor. Some earlier case reports had been suspected genetic background in cervical cancer (CX). The literature was screened and cervical cancer patients from the Department of Obstetrics and Gynecology of the University Hospital of Leipzig were searched for familiar history of malignant tumors at any sites to establish familial risk for CX. Analysis showed, that 15 to 20% of cervical cancer represented at least one first-degree relative with malignant disease any site. The familial relative risk for in situ or invasive CX was reported to range between 1.8 to 2.0 and the heretability was between 0.11 and 0.15 for in situ and 0.22 and 0.33 for the invasive form. In some families a clustering, i.e. two or more female first-degree sibs were affected by CX, was observed, the frequency ranged between 1.7 and 7%. Analyses of risk by age of onset are rarely done and the results are controversy. Two large studies reported an aggregation of tobacco-related and HPV-associated malignancies, like oro-pharyngeal, lung and anorectal sites, in cervical cancer families. Moreover, it has been shown, that both mothers and daughters, who had invasive CX as the first primary cancer, had an excess of lung cancer as a second tumor site. The correlation of HPV-associated neoplasms in affected families suggest a role of mild or moderate hereditary immunosuppression in explaining a part of familial predisposition to cervical cancer are biologically founded. Consequently, this would not imply germ line mutations in oncogenes or tumor suppressor genes but in genes modulating immune response and perhaps causing susceptibility to a variety of viral infections.