A Further Report on the Cancer Family of Warthin

Abstract

The family with numerous deaths from cancer, which was reported by Dr. A. S. Warthin in 1913 (1) and again in 1925 (2), has been referred to wherever the intrinsic factor in the etiology of malignancy has been discussed. Now that twenty-three years have passed since the first study of this family, it is appropriate again to bring its history up to date. Just as Warthin9s second report was more complete and more accurate than the first, so it has been possible, by a personal investigation of each branch of this family, to present a more detailed and in a few respects a more exact chart of this large group which in six generations now totals 305 individuals. Although it is convenient to continue to refer to this family as Family G, the present study confirms the fact that the tendency to the development of cancer was present in the family line before the surname of which G is the initial was introduced by marriage. At the time of the first report, in 1913, of the 48 traced descendants of a cancerous grandfather 15 had developed cancer and in 2 others neoplasms had appeared which had not been proved to be malignant. The more complete report of 1925 showed an incidence of 28 neoplasms in a total of 146 individuals comprising the family, but of these only 88 had reached adult life. As now reported (Fig. 1), Family G includes 305 individuals. Since carcinoma has occurred in this family in individuals as young as twenty-five years, that period has been arbitrarily selected as the beginning of the “cancer age” for the family. An age of twenty-five years has been attained by 174 members of this family, of whom 41 have developed malignant neoplasms, an incidence of 23.6 per cent. As will appear later, there are two branches of the family in which malignant disease has never appeared. If the 25 in these two lines, who attained the “cancer age,” are excluded from the total of 174, the incidence of malignant disease in the other eight lines of the family becomes 27.5 per cent. These values for cancer incidence become all the more significant when it is borne in mind that, while it has been necessary to assume a low limit of twenty-five years for the “cancer age,” the average age at which cancer has been diagnosed in this family, or at which death from cancer has occurred, as the case may be, is 48.3 years.