Colonoscopy vs colon cancer?

[Guest guest]

Hi All,

My next younger brother died at the age of 31 years from colon cancer. I may

require a colonoscopy, based on the below and my not having had one in five

years.

Colonoscopy colon cancer risk reductions are detailed in a new pdf-available

article. See below.

http://www.cbc.ca/story/science/national/2005/10/25/colon-screen051025.html

Prevention of colorectal cancer by colonoscopic surveillance in individuals with

a

family history of colorectal cancer: 16 year, prospective, follow-up study

Isis Dove-Edwin, Sasieni, Joanna , Huw J W

BMJ, doi:10.1136/bmj.38606.794560.EB (published 24 October 2005)

Objective To determine to what extent individuals with various family histories

of

colorectal cancer (from one to three or more affected first degree relatives)

benefit from colonoscopic surveillance.

Design Prospective, observational study of high risk families, followed up over

16

years.

Setting Tertiary referral family cancer clinic in London.

Participants 1678 individuals from families registered with the clinic.

Individuals

were classified according to the strength of their family history: hereditary

non-polyposis colorectal cancer (if they fulfilled the Amsterdam criteria), and

one,

two, or three affected first degree relatives (moderate risk).

Interventions Colonoscopy was initially offered at five year intervals or three

year

intervals if an adenoma was detected.

Main outcome measures The incidence of adenomas with high risk pathological

features

or cancer. This was analysed by age, the extent of the family history, and

findings

on previous colonoscopies. The cohort was flagged for cancer and death.

Incidence of

colorectal cancer and mortality during over 15 000 person years of follow-up

were

compared with those expected in the absence of surveillance.

Results High risk adenomas and cancer were most common in families with

hereditary

non-polyposis colorectal cancer (on initial colonoscopy 5.7% and 0.9%,

respectively). In the families with moderate risk, these findings were

particularly

uncommon under age 45 (1.1% and 0%) and on follow-up colonoscopy if advanced

neoplasia was absent initially (1.7% and 0.1%). The incidence of colorectal

cancer

was substantially lower--80% in families with moderate risk (P=0.00004), and 43%

in

families with hereditary non-polyposis colorectal cancer (P=0.06)--than the

expected

incidence in the absence of surveillance when the family history was taken into

account.

Conclusions Colonoscopic surveillance reduces the risk of colorectal cancer in

people with a strong family history. This study confirms that members of

families

with hereditary non-polyposis colorectal cancer require surveillance with short

intervals. Individuals with a lesser family history may not require surveillance

under age 45, and if advanced neoplasia is absent on initial colonoscopy,

surveillance intervals may be lengthened. This would reduce the demand for

colonoscopic surveillance.

Al Pater, PhD; email: old542000@...

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