Skip to main content
SpringerLink
Log in

Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Persons with a familial risk of colorectal cancer (CRC) account for about 25% of all CRC cases. The adenoma prevalence in relatives of CRC patients 50–60 years of age is 17–34%; data on younger individuals are scarce. Our aim was to prospectively define the adenoma prevalence in 40- to 50-year-old first-degree relatives of CRC patients compared to controls.

Patients and methods

CRC patients were identified via the regional cancer registry, and their 40- to 50-year-old first-degree relatives (risk group) were invited for screening colonoscopy. Additional probands and controls of the same age were recruited by newspaper articles and radio or television broadcastings. Using high-resolution video colonoscopy, each detected polyp was removed and histopathologically assessed. Each participant completed demographic and epidemiological questionnaires.

Results

Of 228 subjects in the risk group 36.4% had polypoid lesions compared to 20.9% of 220 controls (p<0.001). Forty-three (18.9%) subjects in the risk group had adenomas compared to 18 (8.2%) in the control group (p=0.001). High-risk adenomas (>10 mm and/or of villous type) were found in 12 persons in the risk group compared to 5 controls (not significant). In the risk group most lesions (52%) were located proximal to the sigmoid colon compared to 29% in controls.

Conclusions

Subjects between 40–50 years with first-degree relatives with CRC 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. United States Cancer Statistics Working Group (2002) United States cancer statistics: 1999 incidence. Centers for Disease Control and Prevention, Atlanta, GA

    Google Scholar 

  2. Parkin DM, Bray F, Ferlay J, Pisani P (2001) Estimating the world cancer burden: Globocan 2000. Int J Cancer 94:153–156

    Article  PubMed  CAS  Google Scholar 

  3. Winawer SJ, Zauber AG, O'Brien MJ, Ho MN, Gottlieb L, Sternberg SS, Waye JD, Bond J, Schapiro M, Stewart ET (1993) Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. The National Polyp Study Workgroup. N Engl J Med 328:901–906

    Article  PubMed  CAS  Google Scholar 

  4. Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology 124:544–560

    Article  PubMed  Google Scholar 

  5. Winawer SJ, Fletcher RH, Miller L (1997) Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology 112:594–642

    Article  PubMed  CAS  Google Scholar 

  6. Schmiegel W, Adler G, Fruhmorgen P, Folsch U, Graeven U, Layer P, Petrasch S, Porschen R, Pox C, Sauerbruch T (2000) Colorectal carcinoma: prevention and early detection in an asymptomatic population-prevention in patients at risk—endoscopic diagnosis, therapy and after-care of polyps and carcinomas. German Society of Digestive and Metabolic Diseases/Study Group for Gastrointestinal Oncology. Z Gastroenterol 38:49–75

    Article  PubMed  CAS  Google Scholar 

  7. Guillem JG, Forde KA, Treat MR (1992) Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of colon cancer patients. Dis Colon Rectum 35(6):523–529

    Article  PubMed  CAS  Google Scholar 

  8. Gaglia P, Atkin WS, Whitelaw S (1995) Variables associated with the risk of colorectal adenomas in asymptomatic patients with a family history of colorectal cancer. Gut 36:385–390

    Article  PubMed  CAS  Google Scholar 

  9. Sauar J, Hausken T, Hoff G (1992) Colonoscopic screening examination of relatives of patients with colorectal cancer. Scand J Gastroenterol 27:661–666

    Article  PubMed  CAS  Google Scholar 

  10. Rex DK, Lehman GA, Ulbright TM (1993) Colonic neoplasia in asymptomatic persons with negative fecal occult blood test: influence of age, gender, and family history. Am J Gastroenterol 88(6):825–831

    PubMed  CAS  Google Scholar 

  11. Pariente A, Milan C, Lafon J, Faivre J (1998) Colonoscopic screening in first-degree relatives of patients with ‘sporadic’colorectal cancer: a case control study. Gastroenterology 115:7–12

    Article  PubMed  CAS  Google Scholar 

  12. Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF (2002) Results of screening colonoscopy among persons 40 to 49 years of age. N Engl J Med 346:1781–1785

    Article  PubMed  Google Scholar 

  13. Burt RW, Bishop DT, Lynch HT (1990) Risk and surveillance of individuals with heritable factors for colorectal cancer. Bull W H O 68:655–665

    PubMed  CAS  Google Scholar 

  14. Fuchs CS, Giovanucci EL, Colditz GA (1994) A prospective study of family history and risk of colorectal cancer. N Engl J Med 331:1669–1674

    Article  PubMed  CAS  Google Scholar 

  15. Burt RW (1997) Screening of patients with a positive family history of colorectal cancer. Gastrointest Endosc Clin N Am 7:65–79

    PubMed  CAS  Google Scholar 

  16. Winawer SJ, Zauber AG, Ho MN (1993) Prevention of colorectal cancer by colonoscopic polypectomy. New Engl J Med 329:1977–1981

    Article  PubMed  CAS  Google Scholar 

  17. Villavicencio RT, Rex DK (2000) Colonic adenomas: prevalence and incidence rates, growth rates and miss rates at colonoscopy. Semin Gastrointest Dis 11:185–193

    PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Markus Menges

    Present address: Department of Internal Medicine II, Division of Gastroenterology, University of Saarland, Homburg, Germany

Authors and Affiliations

  1. Department of Internal Medicine II, Division of Gastroenterology, University of Saarland, Homburg, Germany

    Johannes Fischinger, Barbara Gärtner & Jochen Raedle

  2. Institute of Medical Biometrics, Epidemiology, and Medical Informatics, University of the Saarland, Homburg, Germany

    Thomas Georg

  3. St.Michael Hospital, Völklingen, Germany

    Dietrich Woerdehoff

  4. Hospital of the Miner's Guild, Püttlingen, Germany

    Matthias Maier

  5. St.Elisabeth Hospital, Saarlouis, Germany

    Matthias Harloff

  6. The Saarland Cancer Registry, Saarbrücken, Germany

    Christa Stegmaier

  7. Department of Internal Medicine I, Charité, Campus Benjamin Franklin, Berlin, Germany

    Martin Zeitz

Authors
  1. Markus Menges
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Johannes Fischinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara Gärtner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Georg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dietrich Woerdehoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matthias Maier
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Matthias Harloff
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Christa Stegmaier
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jochen Raedle
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Martin Zeitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Markus Menges.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Menges, M., Fischinger, J., Gärtner, B. et al. Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study. Int J Colorectal Dis 21, 301–307 (2006). https://doi.org/10.1007/s00384-005-0032-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-005-0032-2

Keywords

Search

Navigation