Screening according to guidelines could miss 10 percent of CRCs diagnosed in relatives
MONDAY, Oct. 28 (HealthDay News) -- For people with a family history of colorectal adenomas and advanced adenomas, the risk of developing colorectal cancer (CRC) is significantly elevated, according to a study published online Oct. 21 in Cancer.
Thérèse M.F. Tuohy, Ph.D., from the University of Utah in Salt Lake City, and colleagues conducted a retrospective, case-control study using data from residents of the state of Utah aged 50 to 80 years who underwent colonoscopy between 1995 and 2009. To investigate the familial aggregation of adenomas and CRC, colonoscopy results were linked with cancer and pedigree information from the Utah Population Database.
The researchers found that, of the 126,936 patients who underwent colonoscopy, 43,189 had adenomas and 5,563 had advanced adenomas (the case population); controls were free of adenomas and were matched to cases based on sex and birth year. The risk of CRC was elevated for first-degree relatives of adenoma cases (relative risk [RR], 1.35) and advanced adenoma cases (RR, 1.68), and for second-degree relatives of adenoma cases (RR, 1.15) compared with controls. If the current screening guidelines (colonoscopy should begin starting at age 40 years for individuals with a first-degree relative diagnosed with CRC or advanced adenoma before age 60 years) were strictly adhered to, about 10 percent of CRCs diagnosed in relatives would have been missed.
"These data should be considered when establishing CRC screening guidelines for individuals and their families," the authors conclude.
Two authors disclosed financial ties to the diagnostics and medical device industries.
Abstract (http://onlinelibrary.wiley.com/doi/10.1002/cncr.28227/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/cncr.28227/full )