BACKGROUND: Guidelines recommend that individuals with a first-degree relative (FDR) diagnosed with colorectal cancer (CRC) or advanced adenoma before age 60 years should undergo colonoscopy starting at age 40 years. The authors quantified the risk of adenomas and CRC in FDRs, second-degree relatives (SDRs), and third-degree relatives (TDRs) of patients diagnosed with adenomas and advanced adenomas. METHODS: A population-based, retrospective, case-control study was performed of residents of the state of Utah aged 50 years to 80 years who underwent colonoscopy between 1995 and 2009 at Intermountain Healthcare or the University of Utah. Controls were selected from the population of colonoscopy patients who were free of adenomas or CRC and matched to each case based on sex and birth year. Colonoscopy results were linked with cancer and pedigree information from the Utah Population Database to investigate the familial aggregation of adenomas and CRC using Cox regression analysis. The unit of analysis was the relatives of cases and controls. RESULTS: Of 126,936 patients who underwent colonoscopy, 43,189 had adenomas and 5563 had advanced adenomas and defined the case population. An elevated risk of CRC was found in FDRs (relative risk [RR], 1.35; 95% confidence interval [95% CI], 1.25-1.46), SDRs (RR, 1.15; 95% CI, 1.07-1.23) of adenoma cases, and in FDRs of advanced adenoma cases (RR, 1.68; 95% CI, 1.29-2.18) compared with controls. Approximately 10% of CRCs diagnosed in relatives would have been missed if the current screening guidelines were strictly adhered to. CONCLUSIONS: Relatives of colonoscopy patients with adenomas and advanced adenomas appear to have a significantly elevated risk of developing colorectal neoplasia. These data should be considered when establishing CRC screening guidelines for individuals and their families.
BACKGROUND: Guidelines recommend that individuals with a first-degree relative (FDR) diagnosed with colorectal cancer (CRC) or advanced adenoma before age 60 years should undergo colonoscopy starting at age 40 years. The authors quantified the risk of adenomas and CRC in FDRs, second-degree relatives (SDRs), and third-degree relatives (TDRs) of patients diagnosed with adenomas and advanced adenomas. METHODS: A population-based, retrospective, case-control study was performed of residents of the state of Utah aged 50 years to 80 years who underwent colonoscopy between 1995 and 2009 at Intermountain Healthcare or the University of Utah. Controls were selected from the population of colonoscopy patients who were free of adenomas or CRC and matched to each case based on sex and birth year. Colonoscopy results were linked with cancer and pedigree information from the Utah Population Database to investigate the familial aggregation of adenomas and CRC using Cox regression analysis. The unit of analysis was the relatives of cases and controls. RESULTS: Of 126,936 patients who underwent colonoscopy, 43,189 had adenomas and 5563 had advanced adenomas and defined the case population. An elevated risk of CRC was found in FDRs (relative risk [RR], 1.35; 95% confidence interval [95% CI], 1.25-1.46), SDRs (RR, 1.15; 95% CI, 1.07-1.23) of adenoma cases, and in FDRs of advanced adenoma cases (RR, 1.68; 95% CI, 1.29-2.18) compared with controls. Approximately 10% of CRCs diagnosed in relatives would have been missed if the current screening guidelines were strictly adhered to. CONCLUSIONS: Relatives of colonoscopy patients with adenomas and advanced adenomas appear to have a significantly elevated risk of developing colorectal neoplasia. These data should be considered when establishing CRC screening guidelines for individuals and their families.
Authors: Ross E Anderson; Heidi A Hanson; Diana Thai; Chong Zhang; Angela P Presson; Kenneth I Aston; Douglas T Carrell; Ken R Smith; James M Hotaling Journal: J Assist Reprod Genet Date: 2018-03-17 Impact factor: 3.412
Authors: Ross E Anderson; Heidi A Hanson; William T Lowrance; Jeffrey Redshaw; Siam Oottamasathien; Anthony Schaeffer; Erica Johnstone; Kenneth I Aston; Douglas T Carrell; Patrick Cartwright; Ken R Smith; James M Hotaling Journal: J Urol Date: 2017-01-26 Impact factor: 7.450
Authors: Elizabeth T Jacobs; Samir Gupta; John A Baron; Amanda J Cross; David A Lieberman; Gwen Murphy; María Elena Martínez Journal: Am J Gastroenterol Date: 2018-02-20 Impact factor: 10.864
Authors: Ross E Anderson; Heidi A Hanson; Darshan P Patel; Erica Johnstone; Kenneth I Aston; Douglas T Carrell; William T Lowrance; Ken R Smith; James M Hotaling Journal: Fertil Steril Date: 2016-06-20 Impact factor: 7.329
Authors: Jan T Lowery; Dennis J Ahnen; Paul C Schroy; Heather Hampel; Nancy Baxter; C Richard Boland; Randall W Burt; Lynn Butterly; Megan Doerr; Mary Doroshenk; W Gregory Feero; Nora Henrikson; Uri Ladabaum; David Lieberman; Elizabeth G McFarland; Susan K Peterson; Martha Raymond; N Jewel Samadder; Sapna Syngal; Thomas K Weber; Ann G Zauber; Robert Smith Journal: Cancer Date: 2016-06-03 Impact factor: 6.860
Authors: Zahra Montazeri; Evropi Theodoratou; Christine Nyiraneza; Maria Timofeeva; Wanjing Chen; Victoria Svinti; Shanya Sivakumaran; Gillian Gresham; Laura Cubitt; Luis Carvajal-Carmona; Monica M Bertagnolli; Ann G Zauber; Ian Tomlinson; Susan M Farrington; Malcolm G Dunlop; Harry Campbell; Julian Little Journal: Int J Epidemiol Date: 2015-10-07 Impact factor: 7.196
Authors: Steffie K Naber; Karen M Kuntz; Nora B Henrikson; Marc S Williams; Ned Calonge; Katrina A B Goddard; Doris T Zallen; Theodore G Ganiats; Elizabeth M Webber; A Cecile J W Janssens; Marjolein van Ballegooijen; Ann G Zauber; Iris Lansdorp-Vogelaar Journal: Gastroenterology Date: 2017-09-28 Impact factor: 22.682