Authors have defined "Cancer Frequent Family (CFF)" as a family that yresents with clustering of different types of cancers among its members, but does not satisfy the arite- ria of any known hereditary cancer syndromes. The inclusion criteria for CFF are: three or more cancer patients (1) among siblings or (2) in more tbsn two successive generations or (3) in 3 or more cousins, with at least one of the patients diagnosed before the age of 50. Gastric cancer after age of 45 and primary liver cancer were excluded. By screening family history of cancer patients admitted to Seoul National University Hospital since l992, nine families fulfiling the CFF criteria were identified. Among 294 family members from these 9 families, thirty-six(12%) were affected with cancer. A total of 41 primary cancers affecting 10 different organs were found, with the average age at diaenosis of the first primary cancer being 47. Five members were affected with double primary cancers; four with 2 colorectal cancers and one with a rectal cancer and a malignant thymoma. Colorectal cancer was by far the most common malignancy encountered, accounting for 5l% of all the malignancies found. The average age at diagnosis of colorectal cancers in CFF was significantly younger than that of sporedic cases(43 vs 56, P<0.01). The incidence of metachronous colorectal cancer was aleo high(24%) in this group. On the basis of familial aggregation, younger age of onset, and multiplicity of tumors in affected individuals, hereditary backgrounds can be suspected in colorectal cancer patients of CFF families. Our resuits indicate that clustering of different malignancies in a family may suggest possible hereditary causes and that regular screening may aid in the early detection of other affected individuals in CFF families
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