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Early Screening of Colorectal Cancer Based on Family History

Findings published online in CANCER, a peer-reviewed journal of the American Cancer Society (ACS) showed that almost all colorectal cancer patients could have been diagnosed earlier if they had been screened according to current family history.

In many countries, colorectal cancer rates rise among adults under 50 years of age. Current guidelines recommend early screening for colorectal cancer among individuals with a family history of the disease for identification of those at risk.

To estimate the potential impact of family history-based guidelines for screening colorectal cancer, Dr Samir Gupta, MD of the VA San Diege Healthcare System and the University of California San Diego, together with his colleagues examined data from the Colon Cancer Family Registry from 1998 to 2007. The investigation involved information on individuals 40 to 49 years of age, of which 2,473 had colorectal cancer and 772 did not.

The investigators found that 25 percent of individuals with colorectal cancer and 10 percent of those without cancer met the criteria for family history-based early screening. Almost all (98.4 percent) patients with colorectal cancer who met these criteria should have been screened at a younger age than when their cancer was diagnosed. Therefore, they could have had their cancer diagnosed earlier, or possibly even prevented, if earlier screening had been implemented based on family history-based guidelines.

“Our findings suggest that using family history-based criteria to identify individuals for earlier screening is justified and has promise for helping to identify individuals at risk for young-onset colorectal cancer,” said Dr. Gupta. “We have an opportunity to improve early detection and prevention of colorectal cancer under age 50 if patients more consistently collect and share their family history of colorectal cancer, and healthcare providers more consistently elicit and act on family history.” [APBN]