Clinical Practice Guideline on Screening for Colorectal Cancer in Individuals With a Family History of Nonhereditary Colorectal Cancer or Adenoma: The Canadian Association of Gastroenterology Banff Consensus

Leddin, Desmond; Lieberman, David A.; Tse, Frances; Barkun, Alan N.; Abou‐Setta, Ahmed M; Marshall, John K.; Samadder, N. Jewel; Singh, Harminder; Telford, Jennifer J.; Tinmouth, Jill; Wilkinson, Anna N.; Leontiadis, Grigorios I

doi:10.1053/j.gastro.2018.08.017

Cited by 72 publications

(91 citation statements)

References 109 publications

(186 reference statements)

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“…We did not address the presence of having a FH of adenomas despite current surveillance recommendations according to different clinical practice guidelines. [5][6][7] Imperiale and Ransohoff 85 conducted a systematic review on the CRC risk of individuals with a positive FH for adenomas and finally selected only 2 relevant studies. They concluded that there is an increased risk for CRC, however, those 2 studies harbored limitations regarding generalizability and validity.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis

Roos

Mangas-Sanjuán

Rodríguez-Girondo

et al. 2019

Clinical Gastroenterology and Hepatology

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This article has an accompanying continuing medical education activity, also eligible for MOC credit, on page e159. Learning Objective-Upon completion of this activity, successful learners will be able to identify the risk for developing colorectal cancer (CRC) related to the type of family history; identify the absolute risk for developing colorectal cancer for individuals with at least one first degree relative (FDR) with CRC younger than 50 years; and define "familial colorectal cancer." BACKGROUND & AIMS: Guidelines recommend that individuals with familial colorectal cancer undergo colonoscopy surveillance instead of average-risk screening. However, these recommendations vary widely. To substantiate appropriate surveillance strategies, precise and valid evidence-based risk estimates are needed for individuals with a family history of colorectal cancer (CRC). METHODS: We systematically searched MEDLINE, EMBASE, and Cochrane from inception to July 2018 for case-control and cohort studies investigating the effect of family history on CRC risk. We calculated summary estimates of pooled relative risks (RRs) using a random-effects model. Life tables were created to convert RR estimates into absolute risk estimates. RESULTS: We screened 4417 articles and identified 42 eligible case-control and 20 cohort studies. In case-control studies, the RR for CRC in patients with 1 first-degree relative (FDR with CRC) was 1.92 (95% CI, 1.53-2.41) and 1.37 (95% CI, 0.76-2.46) for cohort studies. For individuals with 2 or more FDRs with CRC, the RR was 2.81 in case-control studies (95% CI, 1.73-4.55) and 2.40 in cohort studies (95% CI, 1.76-3.28). For individuals having a FDR diagnosed with CRC at an age younger than 50 years, the RR for CRC in their FDRs was 3.57 in case-control studies (95% CI, 1.07-11.85) and 3.26 in cohort studies (95% CI, 2.82-3.77). The cumulative absolute risks for CRC at 85 years in Western Europe were 4.8% for persons with 1 FDR with CRC (95% CI, 2.7%-8.3%), 8.2% for individuals with 2 or more FDRs (95% CI, 6.1%-10.9%), and 11% for persons with a FDR diagnosed with CRC at an age younger than 50 years (95% CI, 9.5%-12.4%). CONCLUSIONS: In this systematic review and meta-analysis, we found that the RR of CRC among FDRs is lower than previously expected, especially based on cohort studies. Risk estimates are affected by the number of relatives with CRC and their age at diagnosis. Intensified colonoscopy surveillance strategies could be considered for high-risk groups. PROSPERO trial identification no: CRD42018103058.

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Section: Discussionmentioning

confidence: 99%

“…According to various clinical practice guidelines, individuals with FCC are recommended to undergo more intensive surveillance strategies than the general population, starting at an earlier age. [5][6][7][8] However, the definition of who should undergo intensified colonoscopy surveillance instead of average-risk screening varies widely.…”

mentioning

confidence: 99%

Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis

Roos

Mangas-Sanjuán

Rodríguez-Girondo

et al. 2019

Clinical Gastroenterology and Hepatology

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“…Colonoscopy should be mandatory in older patients and when there is a personal and/or a family history of colorectal neoplasms or documented advanced adenoma, IBD, history of altered bowel habits, recent significant weight loss, and a laboratory findings of iron deficiency anemia or a positive fecal immunochemical test (FIT) and guaiac-based fecal occult blood test (gFOBT) [25][26][27][28][29][30].…”

Section: Patients With Hd and Rectal Bleeding Should Undergo Colonoscmentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

et al. 2020

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Hemorrhoidal disease (HD) is the most common proctological disease in the Western countries. However, its real prevalence is underestimated due to the frequent self-medication. The aim of this consensus statement is to provide evidence-based data to allow an individualized and appropriate management and treatment of HD. The strategy used to search for evidence was based on application of electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL, and EMBASE. These guidelines are inclusive and not prescriptive. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by American College of Chest Physicians. The recommendations were graded A, B, and C.

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“…63 Guidelines recently published by the Canadian Association of Gastroenterology and endorsed by the American Gastroenterological Association also support starting screening in high-risk individuals at age 40, with a surveillance interval of 5 to 10 years based on the number of first-degree relatives with colorectal cancer or adenomas. 64 Consensus statements were based on retrospective cohort, prospective case-controlled, and cross-sectional stud-ies comparing the risk of colorectal cancer in individuals with a family history against those without a family history.…”

Section: Colonoscopymentioning

confidence: 99%

Colorectal cancer screening: Choosing the right test

Mankaney

Sutton

Burke³

2019

CCJM

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Colorectal cancer, the second most common type of cancer and cause of cancer-related deaths in the United States, can largely be prevented by screening. The 2 most used methods in the United States are colonoscopy and fecal immunochemical testing (FIT). FIT is noninvasive but must be done yearly for optimal performance and, if positive, must be followed by colonoscopy. Colonoscopy is invasive, operator-dependent, and more expensive, but it can detect and remove polyps during the same procedure. The choice of test depends on patient preference, family history, and the likelihood of compliance. KEY POINTS Colorectal cancer rates are increasing in young individuals, with 10,000 new cases reported in 2017 in people ages 20 to 49. The evidence to support screening at ages 45 to 50 is not well established. FIT is noninvasive but requires high patient adherence and the ability to follow a multistep process. Preliminary results from one trial showed it inferior to colonoscopy for detecting colorectal cancer precursors. Colonoscopy allows visualization and removal of precursor lesions. A positive FIT result requires follow-up colonoscopy within 10 months.

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Clinical Practice Guideline on Screening for Colorectal Cancer in Individuals With a Family History of Nonhereditary Colorectal Cancer or Adenoma: The Canadian Association of Gastroenterology Banff Consensus

Cited by 72 publications

References 109 publications

Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis

Effects of Family History on Relative and Absolute Risks for Colorectal Cancer: A Systematic Review and Meta-Analysis

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

Colorectal cancer screening: Choosing the right test

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