Original paper

Cancer Causes & Control

, Volume 25, Issue 10, pp 1329-1336

First online:

Colonoscopy reduced distal colorectal cancer risk and excess cancer risk associated with family history

  • Sophie MoroisAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11
  • , Vanessa CottetAffiliated withRegistre Bourguignon des Cancers Digestifs, Université de BourgogneINSERM U866, Université de BourgogneCHU DIJON, Université de Bourgogne
  • , Antoine RacineAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11
  • , Françoise Clavel-ChapelonAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11
  • , Franck CarbonnelAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11Service d’Hépatogastroentérologie, Centre Hospitalier de Bicêtre
  • , Nadia BastideAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11
  • , Marie-Christine Boutron-RuaultAffiliated withINSERM U1018, Team 9, Institut Gustave Roussy, Espace Maurice TubianaUMRS 1018, Université Paris Sud 11 Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Purpose

Colonoscopy efficacy at preventing proximal colorectal cancer (CRC) is questioned, and little is known about efficacy in high-risk versus medium-risk populations. We investigated the relationship between colonoscopy screening, family history of colorectal cancer (FHCC), and CRC risk by site.

Methods

Among 92,078 women of the E3N prospective cohort, 692 CRCs have been diagnosed after a median follow-up of 15.4 years. Cox proportional hazard models estimated adjusted hazards ratios according to subsites of cancer and FHCC.

Results

A personal history of colonoscopy (PHC; n = 37,470) was associated with decreased rectal and distal colon cancer risks (hazard ratio (HR) = 0.57; 95 % Confidence Interval (CI) = 0.42–0.78 and HR = 0.37; 95 % CI = 0.26–0.52, respectively), but not proximal colon cancer risk (HR = 0.87; 95 % CI = 0.64–1.18). In women with no prior colonoscopy, those with FHCC had a 80 % higher CRC risk than those without FHCC. In women with previous colonoscopy, CRC risk was similar in women with and without FHCC (p for interaction = 0.04).

Conclusions

Results showed colonoscopy ability to prevent distal cancers, but not proximal cancers in women. Colonoscopy screening also reduced the excess risk of women with FHCC to that of women with no FHCC.

Keywords

Colorectal cancer Colonoscopy Family history Prospective study Screening Efficacy