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Extended relatives of colorectal cancer patients at elevated neoplasia risk
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LAS VEGAS — Relatives of patients with colorectal cancer — including first-, second- and third-degree relatives — are at increased risk for developing colorectal neoplasia, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
In a retrospective case-control study, researchers evaluated 126,936 patients aged 50 to 80 years who received colonoscopy between February 1995 and January 2009 in Utah. Within this group, 3,804 patients were diagnosed with colorectal cancer (CRC), and these served as the index cases for the study, in which the risk for colorectal cancer and adenomas among the relatives of index patients was compared with that of matched controls.
“Current guidelines recommend individuals with a first-degree relative (FDR) diagnosed with CRC or advanced adenoma before age 60 should undergo screening colonoscopy starting at age 40,” the researchers wrote. “Our study is the first population-based assessment of the risk of CRC and adenomas in [first-, second- and third-degree relatives] of individuals with CRC.”
CRC was more prevalent among first- (OR=1.79, 1.59-2.03), second- (OR=1.32, 1.19-1.47) and third-degree relatives (OR=1.15, 1.07-1.25) of patients with CRC compared with controls. Adenomas also were more common among all three degrees of relatives (OR=1.82, 1.66-2.00, OR=1.19, 1.08-1.31 and OR=1.10, 1.04-1.17, first, second and third, respectively) (95% CI for all).
Risk for CRC among first-degree relatives was higher when index cases developed cancer younger than aged 60 years (OR=2.17, 1.44-3.27, compared with OR=1.54, 1.28-1.85 in cases diagnosed after age 60). Adenoma risk for relatives was similarly higher among cases diagnosed at a younger age (OR=2.04; 95% CI, 1.74-2.39 compared with OR=1.58; 95% CI, 1.37-1.83).
“Family history is a very important predictor of risk for colorectal cancer,” researcher N.Jewel Samadder, MD, MSc, assistant professor of medicine at the University of Utah, told Healio.com. “[Clinicians] need to take a good family history … and should consider offering earlier colonoscopies, starting at age 40 and repeating every 5 years, if they have a positive family history of someone affected with colorectal cancer.”
For more information:
Samadder NJ. #9: Elevated Risk of Colorectal Cancer and Adenomas in Relatives of Patients with Colorectal Cancer: A Population-based Study in Utah. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.