Abstract Background Individuals with a non-syndromic family history of colorectal cancer are known to have an increased risk. There is an opportunity to prevent early-onset colorectal cancer (age less than 50 years) (EOCRC) in this population. The aim was to explore the proportion of EOCRC that is preventable due to family history of colorectal cancer. Methods This was a retrospective multicentre European study of patients with non-hereditary EOCRC. The impact of the European Society of Gastrointestinal Endoscopy (ESGE), U.S. Multi-Society Task Force (USMSTF), and National Comprehensive Cancer Network (NCCN) guidelines on prevention and early diagnosis was compared. Colorectal cancer was defined as potentially preventable if surveillance colonoscopy would have been performed at least 5 years before the age of diagnosis of colorectal cancer, and diagnosed early if colonoscopy was undertaken between 1 and 4 years before the diagnosis. Results Some 903 patients with EOCRC were included. Criteria for familial colorectal cancer risk in ESGE, USMSTF, and NCCN guidelines were met in 6.3, 9.4, and 30.4 per cent of patients respectively. Based on ESGE, USMSTF, and NCCN guidelines, colorectal cancer could potentially have been prevented in 41, 55, and 30.3 per cent of patients, and diagnosed earlier in 11, 14, and 21.1 per cent respectively. In ESGE guidelines, if surveillance had started 10 years before the youngest relative, there would be a significant increase in prevention (41 versus 55 per cent; P = 0.010). Conclusion ESGE, USMSTF, and NCCN criteria for familial colorectal cancer were met in 6.3, 9.4, and 30.4 per cent of patients with EOCRC respectively. In these patients, early detection and/or prevention could be achieved in 52, 70, and 51.4 per cent respectively. Early and accurate identification of familial colorectal cancer risk and increase in the uptake of early colonoscopy are key to decreasing familial EOCRC.

中文翻译：

---

早发性结直肠癌的家族因素：预防的机会

摘要 背景已知具有非综合征性结直肠癌家族史的个体患结直肠癌的风险增加。该人群有机会预防早发性结直肠癌（年龄小于 50 岁）(EOCRC)。目的是探讨因结直肠癌家族史而可预防的 EOCRC 比例。 方法这是一项针对非遗传性 EOCRC 患者的回顾性多中心欧洲研究。比较了欧洲胃肠内窥镜学会 (ESGE)、美国多社会工作组 (USMSTF) 和国家综合癌症网络 (NCCN) 指南对预防和早期诊断的影响。如果在结直肠癌诊断年龄之前至少 5 年进行监测性结肠镜检查，则结直肠癌被定义为具有潜在可预防性；如果在诊断前 1 至 4 年之间进行结肠镜检查，则结直肠癌被定义为早期诊断。 结果约 903 名 EOCRC 患者被纳入其中。分别有 6.3%、9.4% 和 30.4% 的患者符合 ESGE、USMSTF 和 NCCN 指南中的家族性结直肠癌风险标准。根据 ESGE、USMSTF 和 NCCN 指南，结直肠癌可能在 41%、55% 和 30.3% 的患者中得到预防，而在早期诊断的患者中分别有 11%、14% 和 21.1%。在 ESGE 指南中，如果在最年轻的亲属之前 10 岁开始监测，预防率将会显着提高（41% vs 55%；P = 0.010）。 结论EOCRC 患者分别有 6.3%、9.4% 和 30.4% 符合 ESGE、USMSTF 和 NCCN 家族性结直肠癌标准。在这些患者中，能够实现早期检测和/或预防的比例分别为 52%、70% 和 51.4%。早期准确识别家族性结直肠癌风险并提高早期结肠镜检查的接受率是减少家族性 EOCRC 的关键。