Adding familial risk assessment to faecal occult b... [Eur J Cancer. 2011] - PubMed result

Eur J Cancer. 2011 Feb 28. [Epub ahead of print]

Adding familial risk assessment to faecal occult blood test can increase the effectiveness of population-based colorectal cancer screening.
Dekker N, van Rossum LG, Van Vugt-van Pinxteren M, van Stiphout SH, Hermens RP, van Zelst-Stams WA, van Oijen MG, Laheij RJ, Jansen JB, Hoogerbrugge N.

Department of Human Genetics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.


Abstract
BACKGROUND: The Dutch Health Council recently recommended the introduction of a colorectal cancer (CRC) screening programme by faecal occult blood testing (FOBT) for individuals aged 55-75 at population risk of CRC. Individuals at an increased familial CRC risk (⩾2 times population risk) should be identified at a younger age, so they and their relatives can receive earlier, more intensive surveillance instead of FOBT.

AIMS: To determine the percentage of participants with a positive FOBT in a CRC screening programme with an increased familial CRC risk.

METHODS: In a population-based study, 10,569 individuals aged 50-75 received an FOBT. Individuals with a positive FOBT were invited for colonoscopy and familial risk assessment. Participants with an average familial CRC risk were compared to those with an increased risk. Increased familial CRC risk was defined as a cumulative lifetime risk of CRC of at least 10%.

RESULTS: Of 6001 participants, 430 had a positive FOBT, of whom 324 (63% males; mean age 63years) completed colonoscopy and familial risk assessment. CRC (n=22) and/or advanced adenomas (n=122) were found in 133 participants. Familial CRC risk was increased in 6% of participants with a positive FOBT. No significant differences were found between participants with an average versus an increased familial CRC risk.

CONCLUSION: Six percent of participants with a positive FOBT had an increased familial CRC risk. Identifying at-risk participants enables them and their relatives to undergo regular colonoscopies. Adding familial risk assessment to FOBT screening may thus prevent a substantial number of CRCs.

Copyright © 2011 Elsevier Ltd. All rights reserved.
PMID: 21367600 [PubMed - as supplied by publisher]

Adding familial risk assessment to faecal occult b... [Eur J Cancer. 2011] - PubMed result