tailieunhanh - Gastrointestinal Oncology - part 3

Vai trò của các yếu tố nguy cơ tiềm năng khác như giới tính, chủng tộc, chế độ ăn uống, hoặc nghề nghiệp chưa được kiểm tra trong môi trường gia đình. Tuy nhiên, tất cả các bệnh nhân có tiền sử gia đình ung thư tuyến tụy nên được khuyên không nên hút thuốc. | 74 Chapter 5 Figure 5-1. Earlier onset and increased risk of pancreatic cancer in members of familial pancreatic cancer kindreds who smoke. Reprinted from Gastroenterology Vol. 124 5 1292-9 Rulyak SJ et al Risk factors for the development of pancreatic cancer in familial pancreatic cancer kindreds Copyright 2003 with permission from the American Gastroenterological Association. 20 years. The roles of other potential risk factors such as race gender diet or occupation have yet to be examined in the familial setting. Nonetheless all patients with a family history of pancreatic cancer should be advised not to smoke. Identification of Patients at Risk for Familial Pancreatic Cancer The identification of patients at increased risk for familial pancreatic cancer can be challenging because familial aggregation of pancreatic cancer may be influenced by a number of factors including chance family size shared environmental exposures and incomplete gene penetrance. For example a shared environmental factor could hypothetically result in multiple first-degree relatives with pancreatic cancer. Conversely if a parent with a pancreatic cancer gene with complete penetrance has 4 children there is a chance that none of the children will be affected. If this hypothetical gene is also incompletely penetrant the chance that no offspring will be affected is even greater. Furthermore it can be difficult or impossible to obtain accurate family history data for such a rapidly and uniformly fatal disease and the clinician is often unable to elicit an accurate family history for more than one or two generations of a family. For these reasons there is currently no clear consensus on the definition of familial pancreatic cancer. However families known to segregate mutations associated with cancer syndromes and those patients with hereditary pancreatitis should be considered at increased risk. It also appears that the absolute number of affected first-degree relatives is correlated with .

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