High detection rate of adenomas in familial colorectal cancer

Abstract

The yield of colonoscopic surveillance in familial CRC is substantially higher than the yield of screening reported for the general population.

Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening program

“…Colorectal findings in our screening population are similar to those observed in other studies 12,[14][15][16][17][18][19][20][21] ; in these studies, the prevalence of advanced colorectal neoplasia ranges from 6.7% to 13.3%. In a smaller case-control study done in France, 12 advanced colorectal neoplasia was significantly more frequent in FDRs (OR 2.6) than controls.…”

“…In our study, 1252 FDRs underwent screening colonoscopy, which is one of the largest groups of FDRs evaluated. The results of published studies are questionable because of small populations, [12][13][14][15][16]18 retrospective design, 13,15,16 lack of a control group, [14][15][16]18,19 lack of procedural information, 13,15 or cecal intubation rates less than 95%. 14,17,19 Few studies [12][13][14]19 have evaluated colorectal findings in the real world of a population-based screening program.…”

“…Furthermore, the strength of a CRC FH was defined according to current screening guidelines, [8][9][10] but different definitions have been used in other studies. 7,19,22 We have also not taken into account that a positive second-and third-degree relative FH of CRC can have a significant effect on a person's risk of CRC. 27 The low values of R N 2 suggest that other potential predictors of colorectal neoplasia risk should be evaluated; we did not collect data on other environmental factors such as dietary habits and drug consumption.…”

“…Few studies [12][13][14][15][16][17][18][19] have evaluated the risk of adenomas among FDRs undergoing a screening colonoscopy. In our study, 1252 FDRs underwent screening colonoscopy, which is one of the largest groups of FDRs evaluated.…”

Colonoscopy findings in high-risk individuals compared to an average-risk control population

“…This is important to bear in mind when examining these patient groups and to have an expectancy of frequent adenoma finding. These results support the assumption that a family history of CRC increases the risk for adenomas also where LS is not diagnosed [26][27][28][29][30]. In the OCR group, the difference was not statistically significant, although a tendency could be seen.…”