Should relatives of patients with colorectal cancer be screened?

Abstract

There is a critical need for standardization in future studies. Furthermore, as there are no studies that document decreased overall mortality from colorectal cancer in first-degree relatives as a result of screening, the decision as to whether to screen this population needs to be based on future prospective controlled trials.

The Management of Adenocarcinoma of the Rectum

“…3 A history of abdominal distension after eating may indicate impending obstruction and the need for a stoma prior to adjuvant radiotherapy.…”

Practice Parameters for the Management of Colonic Cancer Ii: Other Issues. Recommendations of the Colorectal Surgical Society of Australia

“…In the presence of a single first degree relative (FDR), the relative risk of developing CRC approximates to double that of the general population but the risk is significantly increased to three‐ to six‐fold in the presence of two affected FDR 13 –15 , 21 . While the yield for screening average risk individuals below the age of 50 is low, a review of 20 studies performed by Brewer et al suggests that the incidence of significant polyps and CRC in relatives above the age of 40 is sufficient to warrant surveillance beginning at this age 22 . This shift in ‘age at risk’ for individuals with a positive family history has been demonstrated in a controlled trial of surveillance colonoscopy in first degree relatives 19 .…”