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Effectiveness of a colonoscopic screening programme in first‐degree relatives of patients with colorectal cancer
Author(s) -
Puente Gutiérrez J. J.,
Marín Moreno M. A.,
Domínguez Jiménez J. L.,
Bernal Blanco E.,
Díaz Iglesias J. M.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02577.x
Subject(s) - medicine , first degree relatives , colorectal cancer , colonoscopy , odds ratio , asymptomatic , cancer , sibling , gastroenterology , adenoma , family history , oncology , psychology , developmental psychology
Aim The study aimed to assess the diagnostic yield of a colonoscopy screening programme in first‐degree relatives of colorectal cancer (CRC) patients and to identify factors associated with advanced neoplasia. Method We conducted a cross‐sectional study. Individual characteristics, family trees and colonoscopy findings of asymptomatic first‐degree relatives of CRC patients were collected. The findings were classified into cancer (invasive carcinoma and/or non‐invasive high‐grade neoplasia), high‐risk adenomas (≥ 10 mm and/or a villous component) and low‐risk adenomas (tubular < 10 mm). The dependent variable was the presence of advanced neoplasia, defined as cancer and/or high‐risk adenoma. Results Two hundred and sixty‐three relatives (147 females), 50.0 ± 11.5 (range, 25–75) years of age, agreed to participate out of a total of 618 who were invited (acceptance rate 42.5%). Index cases were diagnosed at 63.8 ± 12.4 (range, 37–88) years of age. The closest familial relationship was parent/offspring in 168 (63.9%) participants and sibling in 95 (36.1%) participants; 14.8% had three or more relatives with CRC/cancer associated with Lynch syndrome, and two or more affected generations were identified in 24.0%. Advanced neoplasia was found in 56 (21.3%) participants. Of these, invasive cancer, non‐invasive high‐grade neoplasia and high‐risk adenomas were detected in five (1.9%), six (2.3%) and 45 (17.1%) participants, respectively. Low‐risk adenomas were detected in 20 (7.6%) participants. Male sex (odds ratio, 2.59; P = 0.003) and sibling relationship (odds ratio, 2.74; P = 0.001) were independently associated with advanced neoplasia. Conclusion We detected advanced neoplasia in a considerable number of participants. Our data support colonoscopy screening in first‐degree relatives of patients with CRC at an earlier age than in the medium‐risk population. Male sex and sibling relationship were predictors of advanced neoplasia.