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To the Editor: Dr Chan and colleagues¹ studied the association between self-reported family history of colorectal cancer and survival in a cohort of patients with stage III colorectal cancer receiving adjuvant chemotherapy. Their conclusions were that cancer recurrence was lower and survival greater in patients with a positive family history. We believe that a flawed study design precludes reaching these conclusions.

The first concern is the absence of data on the persons who were not included or who were excluded. Data are available only for stage III colorectal cancer patients. The cancer stage and family history distribution in the original population might have differed extensively, which could account for the differences in cancer recurrence between the groups with and without family history. Also, persons who died of colorectal cancer before family history data could be collected were excluded. Although this was a small group, if a significant proportion of these . . . [Full Text of this Article]

Leo G. M. van Rossum, MS
l.vanrossum@mdl.umcn.nl

Martijn G. H. van Oijen, MS; Jan B. M. J. Jansen, MD, PhD
Department of Gastroenterology and Hepatology
Radboud University Nijmegen Medical Center
Nijmegen, the Netherlands

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