Original article
Clinical endoscopy
Family history of colorectal cancer and prevalence of advanced colorectal neoplasia in asymptomatic screened populations in different age groups

https://doi.org/10.1016/j.gie.2020.01.033Get rights and content

Background and Aims

The clinical significance of a family history (FH) of colorectal cancer (CRC) in first-degree relatives (FDRs) in CRC screening stratified by different age groups of screened individuals is not fully understood. We investigated the relationship between FH and the presence of advanced colorectal neoplasia (ACN) in screened individuals in different age groups.

Methods

Data from screened individuals aged 40 to 54 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.

Results

Among individuals aged 40 to 54 years, the prevalence of ACN was significantly higher in 249 individuals with affected FDRs than in those without (5.6% vs 1.6%; P < .01), with an adjusted odds ratio of 3.7 (95% confidence interval, 1.9-7.0; P < .01); the prevalence was particularly high in those having FDRs with CRC mortality (7.3%). Among individuals aged 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%; P = .95); however, individuals with 2 FDRs with CRC and mortality showed a high prevalence of ACN (17.4% and 42.9%, respectively).

Conclusions

An FH of CRC in FDRs was associated with a higher prevalence of ACN in younger individuals, with a particularly high impact of FH of CRC mortality. In contrast, the impact of FH was weaker in older individuals except those having 2 FDRs with CRC or mortality.

Section snippets

Study setting and design

This study was approved by the Ethics Committee for Clinical Research of the National Cancer Center in Tokyo, Japan. The study was conducted using the database of screened individuals at the Cancer Screening Center of the National Cancer Center in Tokyo, Japan. The Cancer Screening Center was founded in February 2004 to prospectively evaluate cancer screening programs.19,20 Since then, opportunistic cancer screening has been provided for asymptomatic average-risk individuals; total colonoscopy

Baseline characteristics of screened individuals aged 40 to 54 and 55 to 69 years

A flowchart of the data used in this study is shown in Figure 1. Data from 4884 asymptomatic screened individuals were used. None of these individuals had inflammatory bowel disease, a history of bowel resection, or an FH of hereditary CRC.

Of 2263 screened individuals aged 40 to 54 years, 249 (11.0%) had FDRs with CRC. No significant difference in the baseline characteristics was observed between these 249 individuals with affected FDRs and the remaining 2014 individuals without affected FDRs (

Discussion

The present study demonstrated the clinical significance of an FH of CRC in FDRs as a risk factor for ACN in younger asymptomatic screened individuals aged 40 to 54 years. In contrast, a positive FH had a weaker impact on relatively older screened individuals aged 55 to 69 years except those with 2 affected FDRs. Under the current circumstances in which no consensus has been reached regarding the relationship between the age of screened individuals and the influence of FH, the findings from our

Acknowledgments

We thank H. Nikki March, PhD, and Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac) and Editage (www.editage.com) for editing a draft of this manuscript.

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  • DISCLOSURE: All authors disclosed no financial relationships. Research support for this study was provided by JSPS KAKENHI (grant no. 17K15978) (M.S.) and the National Cancer Center Research and Development Fund (30-A-16) (M.S., T.M.).

    If you would like to chat with an author of this article, you may contact Dr Sekiguchi at [email protected].

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