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In estimating familial risks from family data one must be careful that ascertainment of families does not depend on family history, otherwise the estimates might not be applicable even to the setting from which the families were ascertained. In this regard, Boparai et al1 reported the largest study to date examining the risk of colorectal cancer (CRC) and hyperplastic polyposis syndrome (HPS) for first-degree relatives (FDRs) of HPS patients. They found that the FDRs of the studied HPS patients had five times the incidence of CRC (relative risk, RR=5.4; 95% CI 3.7 to 7.8), and 39 times the incidence of HPS (RR=39; 95% CI 13 to 121) compared to people from the general population. They interpreted the RR estimates as applying to relatives of …
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