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News

Screening colonoscopy for familial colorectal cancer risk is efficient

Subjects between 40 to 50 years with first-degree relatives with colorectal cancer have a higher prevalence of adenomas, and a tendency towards a more proximal location, finds the latest International Journal of Colorectal Diseases.

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Persons with a familial risk of colorectal cancer account for about 25% of all colorectal cancer cases.

The adenoma prevalence in relatives of colorectal cancer patients 50 to 60 years of age is 17% to 34%.

However, data on younger individuals are scarce.

Dr Markus Menges and colleagues from Germany prospectively defined the adenoma prevalence in 40- to 50-year-old first-degree relatives of colorectal cancer patients.

The investigative team identified colorectal cancer patients via the regional cancer registry.

The 40- to 50-year-old first-degree relatives of these patients, termed the ‘risk group', were invited for screening colonoscopy.

The team recruited additional probands and controls of the same age by newspaper articles and radio or television broadcastings.

19% in the risk group had adenomas vs 8% in the control group
International Journal of Colorectal Diseases

Using high-resolution video colonoscopy, each detected polyp was removed and histopathologically assessed.

Each participant completed demographic and epidemiological questionnaires.

The investigators found of 228 subjects in the risk group, 36% had polypoid lesions compared to 21% of 220 controls.

The team observed that 19% in the risk group had adenomas compared to 8% in the control group.

High-risk adenomas were found in 12 persons in the risk group compared to 5 controls.

The investigators noted that, in the risk group, 52% of lesions were located proximal to the sigmoid colon compared to 29% in controls.

Dr Menges' team concluded, “Subjects between 40 to 50 years with first-degree relatives with colorectal cancer demonstrate a significantly higher prevalence of adenomas than controls, with a tendency towards a more proximal location.”

“These data support a screening colonoscopy in persons with familial risk already between 40 and 50 years.”

Int J Col Dis2006: 21(4): 301-7
18 April 2006

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