How is the increased risk of colorectal cancer in first-degree relatives of patients communicated?

Sulz, Michael Christian; Meyenberger, Christa; Sawatzki, Mikael

doi:10.1097/01.meg.0000437202.78275.4a

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…In line with previous studies, adding counseling improved knowledge about screening colonoscopy but did not increase the uptake rate any further (5,16).…”

Section: Discussionsupporting

confidence: 88%

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Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

Bauer

Riemann

Seufferlein

et al. 2018

Deutsches Ärzteblatt International

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Background: Screening colonoscopy can lower the incidence of colorectal cancer (CRC), yet participation rates are low even in groups at high risk. The goal of this study was to double the rate of participation in screening colonoscopy among persons at familial risk and then to determine the frequency of neoplasia in this risk group. Methods: In a nationwide, cluster-randomized, multicenter study, first-degree relatives (FDR) of patients with CRC across Germany received written informational materials concerning the familial risk of CRC, along with an invitation to undergo colonoscopy. Participants in the intervention group were additionally counseled by nurses over the telephone. The primary endpoint of the study was colonoscopy uptake within 30 days. Results: The participants' mean age was 50.8 years. The colonoscopy uptake rates were 99/125 (79%) in the intervention group and 97/136 (71%) in the control group (RR = 1.11; 95% confidence interval [0.97; 1.28]). A polypectomy was performed in 72 of 196 asymptomatic persons (37%). In 13 cases (7%), an advanced neoplasia was detected; two of these persons had colon cancer (stages T0 and T1). 42% of the participants expressed barriers against colonoscopy. 22 reported mild side effects; there were no serious side effects. Conclusion: Additional counseling by nurses over the telephone does not increase the participation rate. Approaching patients who have CRC is an opportunity to increase the participation of their first-degree relatives in screening colonoscopy. The frequency of neoplasia that was found in this study underscores the need to screen relatives even before they reach the usual age threshold for screening.

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“…In line with previous studies, adding counseling improved knowledge about screening colonoscopy but did not increase the uptake rate any further (5,16).…”

Section: Discussionsupporting

confidence: 88%

“…First-degree relatives (FDR) of persons with CRC are 2 to 4 times more likely to develop CRC themselves (2,3). The need for a more intense screening of this population is thus supported by empirical data (4,5).…”

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confidence: 99%

Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

Bauer

Riemann

Seufferlein

et al. 2018

Deutsches Ärzteblatt International

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“…Individuals with first-degree relatives (FDRs) with CRC have a 2 to 4-fold higher risk of developing this cancer 2 , together with an increased-risk of presenting advanced adenomas (AA) 3 . The most accurate but invasive detection technique for tumours and adenomas is the colonoscopy, with an adherence lower than 43% in this population 4 5 .…”

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confidence: 99%

Serum matrix metalloproteinase-9 in colorectal cancer family-risk population screening

Otero-Estévez

Chiara

Rodríguez-Girondo

et al. 2015

Sci Rep

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Matrix metalloproteinase-9 (MMP-9) is related to tumour development and progression in colorectal cancer (CRC) and its utility as biomarker has been suggested. The aim of our study was to measure serum MMP-9 in asymptomatic first-degree relatives of CRC patients, and to analyse its diagnostic accuracy for the detection of advanced neoplasia (AN: advanced adenomas and CRC). Additionally, we compared its diagnostic capability with the most used non-invasive faecal immunochemical test (FIT). Serum MMP-9 was quantified by ELISA in 516 asymptomatic individuals that underwent a colonoscopy and a FIT. MMP-9 levels were significantly related to age and gender and therefore the concentration was corrected by these confounders. Corrected MMP-9 (cMMP-9) levels were higher in individuals with advanced adenomas (AA; p-value = 0.029) and AN (p-value = 0.056) compared to individuals with no neoplasia. Moreover, elevated cMMP-9 concentration was associated with more severe characteristics of adenomas (number of lesions, size and histology). Nevertheless, the diagnostic accuracy of cMMP-9 was considerably lower than that of FIT for identifying AA (22.64% vs. 47.17% sensitivity, 90% specificity) or AN (19.30% vs. 52.63% sensitivity, 90% specificity). According to our results, serum MMP-9 cannot be considered of utility for the diagnosis of AN in CRC family-risk population screening.

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“…Several epidemiological risk factors have been established for CRC, including age and sex, as well as other CRC-specific factors like family history of CRC and inflammatory bowel disease (reviewed in Brenner et al , 2014 ). Individuals with first-degree relatives (FDR) with CRC, especially with multiple affected relatives or relatives diagnosed at young ages, have a two- to fourfold higher risk of developing CRC ( Butterworth et al , 2006 ; Sulz et al , 2014 ).…”

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confidence: 99%

Serum sCD26 for colorectal cancer screening in family-risk individuals: comparison with faecal immunochemical test

et al. 2014

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Background:The development of specific screening programs for individuals with a family history of colorectal cancer (CRC) is a priority. This study evaluates the diagnostic performance of serum soluble CD26 (sCD26) in family-risk individuals and compares this marker with the faecal immunochemical test for the detection of advanced neoplasia (AN) (CRC or advanced adenomas; AA).Methods:Five hundred and sixteen asymptomatic individuals with at least one first-degree relative with CRC were included. Serum sCD26 was measured in all the individuals who also underwent a colonoscopy (53 AA and four cancer cases were found) and a faecal immunochemical test.Results:Setting specificity to 90% and 95%, respectively, sCD26 showed a sensitivity of 39.6% and 28.3% for AA, and of 42.1% and 28.1% for AN. The combination of sCD26 and the faecal test detected AA and AN with a 52.8% and 56.1% sensitivity, corresponding to 93.5% specificity.Conclusions:The combination of serum sCD26 and the faecal blood test could result a valuable strategy for detecting AN in familial-risk CRC screening.

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How is the increased risk of colorectal cancer in first-degree relatives of patients communicated?

Abstract: In Switzerland, CRC patients and their FDRs are well informed about FDRs' increased CRC risk. However, the majority of FDRs do not undergo the recommended CRC screening.

Cited by 5 publications

References 23 publications

Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer

Serum matrix metalloproteinase-9 in colorectal cancer family-risk population screening

Serum sCD26 for colorectal cancer screening in family-risk individuals: comparison with faecal immunochemical test

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