International Journal of Colorectal Disease

, Volume 21, Issue 4, pp 301–307

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

  • Markus Menges
  • Johannes Fischinger
  • Barbara Gärtner
  • Thomas Georg
  • Dietrich Woerdehoff
  • Matthias Maier
  • Matthias Harloff
  • Christa Stegmaier
  • Jochen Raedle
  • Martin Zeitz
Original Article

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 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Markus Menges
    • 1
  • Johannes Fischinger
    • 1
  • Barbara Gärtner
    • 1
  • Thomas Georg
    • 2
  • Dietrich Woerdehoff
    • 3
  • Matthias Maier
    • 4
  • Matthias Harloff
    • 5
  • Christa Stegmaier
    • 6
  • Jochen Raedle
    • 1
  • Martin Zeitz
    • 7
  1. 1.Department of Internal Medicine II, Division of GastroenterologyUniversity of SaarlandHomburgGermany
  2. 2.Institute of Medical Biometrics, Epidemiology, and Medical InformaticsUniversity of the SaarlandHomburgGermany
  3. 3.St.Michael HospitalVölklingenGermany
  4. 4.Hospital of the Miner's GuildPüttlingenGermany
  5. 5.St.Elisabeth HospitalSaarlouisGermany
  6. 6.The Saarland Cancer RegistrySaarbrückenGermany
  7. 7.Department of Internal Medicine I, CharitéCampus Benjamin FranklinBerlinGermany

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