Evaluation of a population‐based approach to familial colorectal cancer

Abstract

As Newfoundland has the highest rate of familial colorectal cancer (CRC) in the world, we started a population‐based clinic to provide colonoscopic and Lynch syndrome (LS) screening recommendations to families of CRC patients based on family risk. Of 1091 incident patients 51% provided a family history. Seventy‐two percent of families were at low or intermediate–low risk of CRC and colonoscopic screening recommendations were provided by letter. Twenty‐eight percent were at high and intermediate–high risk and were referred to the genetic counsellor, but only 30% (N = 48) were interviewed by study end. Colonoscopy was recommended more frequently than every 5 years in 35% of families. Lower family risk was associated with older age of proband but the frequency of screening colonoscopy recommendations varied across all age groups, driven by variability in family history. Twenty‐four percent had a high MMR predict score for a Lynch syndrome mutation, and 23% fulfilled the Provincial Program criteria for LS screening. A population‐based approach in the provision of colonoscopic screening recommendations to families at risk of CRC was limited by the relatively low response rate. A family history first approach to the identification of LS families was inefficient.

Universal Tumor Screening for Lynch Syndrome: Perspectives of Patients Regarding Willingness and Informed Consent

“…Participants wanted to be informed about screening for LS at the time of diagnosis by almost any healthcare professional. Given the scarcity of genetic counsellors across Canada and the long wait times for counselling services, this finding has practical implications [30,32]. Other healthcare professionals such as primary care physicians, nurses and surgeons could have a role in educating patients about tumor testing, and guidelines to assist healthcare professionals in this role have been described [63,[65][66][67].…”

Multimedia Teaching Quality Evaluation System in Colleges Based on Genetic Algorithm and Social Computing Approach

“…Fifth, the most commonly used termination criterion in QPSO algorithm is to reach the maximum iteration number G, or meet a good enough adaptive value, or the optimal solution stops changing. If one of the above conditions is satisfied, the algorithm will be terminated [35], [36].…”

Universal tumor screening for Lynch syndrome: perspectives of Canadian pathologists and genetic counselors

“…In our jurisdiction, universal tumor screening might be particularly important. NL has the highest incidence of CRC in Canada, along with the highest CRC mortality rate (Canadian Cancer Society 2017; Parfrey et al 2017). Compared to other population-based studies, NL also has the highest rate of familial colon cancer worldwide (Green et al 2007).…”