Family History of Colorectal Cancer and Prevalence of Advanced Colorectal Neoplasia in Screening

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To evaluate the clinical significance of family history (FH) of colorectal cancer (CRC) in first degree relatives (FDRs) in screening stratified by different age groups, investigation of the relationship between FH and the presence of advanced colorectal neoplasia (ACN), and screened individuals in different age groups were evaluated.

Data from screened individuals aged 40 to 45 years (N = 2263), and 55 to 69 years (N = 2621), who underwent their first-ever screening colonoscopy, were analyzed. The relationship between FH and ACN was examined and a multivariate logistic regression analysis incorporating other baseline characteristics was performed.

Among individuals age 40 to 55 years, the prevalence of ACN was significantly higher in 249 individuals with affected FDRs than in those without (5.6% vs 1.6%), with an adjusted odds ratio of 3.7. The prevalence was particularly high in those having FDRs with CRC mortality (7.3%). Among individuals age 55 to 69 years, the prevalence of ACN was not significantly different between 291 individuals with affected FDRs and those without (5.8% vs 5.8%). However, individuals with two FDRs with CRC and mortality showed a high prevalence of ACN (17.4% and 42.9%, respectively).

It was concluded that an FH of CRC in FDRs was associated with a higher prevalence of ACN in younger individuals with a particularly high impact of FH on CRC mortality. In contrast, the impact of FH was weaker in older individuals, except those having two FDRs with CRC on mortality.

Sekiguchi, M., Kakujawa, Y., Nakamura, K., et al. “Family History of Colorectal Cancer and Prevalence of Advanced Colorectal Neoplasia in Asymptomatic Screened Populations in Different Age Groups.” Gastrointestinal Endoscopy 2020; Vol. 91, pp. 1361-1370.

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