Original Article

International Journal of Colorectal Disease

, Volume 21, Issue 4, pp 301-307

First online:

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

  • Markus MengesAffiliated withDepartment of Internal Medicine II, Division of Gastroenterology, University of Saarland Email author 
  • , Johannes FischingerAffiliated withDepartment of Internal Medicine II, Division of Gastroenterology, University of Saarland
  • , Barbara GärtnerAffiliated withDepartment of Internal Medicine II, Division of Gastroenterology, University of Saarland
  • , Thomas GeorgAffiliated withInstitute of Medical Biometrics, Epidemiology, and Medical Informatics, University of the Saarland
  • , Dietrich WoerdehoffAffiliated withSt.Michael Hospital
  • , Matthias MaierAffiliated withHospital of the Miner's Guild
  • , Matthias HarloffAffiliated withSt.Elisabeth Hospital
  • , Christa StegmaierAffiliated withThe Saarland Cancer Registry
  • , Jochen RaedleAffiliated withDepartment of Internal Medicine II, Division of Gastroenterology, University of Saarland
    • , Martin ZeitzAffiliated withDepartment of Internal Medicine I, Charité, Campus Benjamin Franklin

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

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.

Keywords

Screening colonoscopy Colorectal adenoma Colorectal cancer Familial risk Risk factors