Background: Reproductive factors have been shown by epidemiology studies to alter colorectal cancer (CRC) risk in women. Familial adenomatous polyposis (FAP) patients carry a germline adenomatous polyposis coli (APC) mutation predisposing to multiple adenoma formation in the intestine. Min mice provide a good model of FAP, and we reported recently a significant increase in intestinal tumour multiplicity in a recombinant line of mice following pregnancy.
Aim: We considered whether reproduction modulates intestinal tract disease in a large cohort of female FAP patients (n=180).
Results: Multiple regression analysis showed that the number of colonic polyps observed was not related to the individual's pregnancy status and/or the position of their APC germline mutation. The proportion of females attaining a high Spigelman stage (3 or 4) was unrelated to having a pregnancy prior to attaining the maximum Spigelman stage (p=0.6). On the other hand, having a pregnancy significantly increased the proportion of females that attained the highest Spigelman stage when their APC germline mutation occurred within the mutation cluster region or at or after codon 1020 (50%, 6/12, p=0.005 and 42%, 13/31, p= 0.006, respectively; multivariable logistic regression).
Conclusion: Our data suggest that reproduction may influence disease severity in the upper gastrointestinal tract in FAP patients.
- gastrointestinal disease
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