Current Colon Cancer Screening Guidelines Might Miss Some Patients10/25/13
FRIDAY, Oct. 25 (HealthDay News) -- Current U.S. colon cancer
screening guidelines may result in 10 percent of colon cancers
being missed in people with a family history of colon polyps that
can lead to cancer, a new study suggests.
"The biggest surprise was the percentage of missed cancers under the current guidelines. We figured there would be a few percent, but 10 percent is a large number," study author Dr. N. Jewel Samadder, of the Huntsman Cancer Institute at the University of Utah, said in a university news release.
Colorectal cancer is the third most common cancer in the United
States and the second deadliest.
Samadder's team looked at data from nearly 127,000 people, aged
50- to 80, who underwent colonoscopy in Utah between 1995 and 2009.
They found that first-degree relatives -- parents, siblings,
children -- of people with adenomas (polyps linked to cancer) or
advanced adenomas had a 35 percent to 70 percent increased risk of
developing colon cancer than relatives of patients without these
Second-degree relatives (aunts, uncles, grandparents) and
third-degree relatives (cousins, nieces, nephews,
great-grandparents) of people with adenomas were also at increased
risk for colon cancer, according to the study published online Oct.
25 in the journal
"We expected to see increased risk in first-degree relatives, but we weren't sure the risk would also be higher for more distant relatives in multiple generations," Samadder said.
Current national guidelines for colon cancer screening recommend
colonoscopy every 10 years starting at age 50 for the general
population. But first-degree relatives of people diagnosed with
either colorectal cancer or advanced adenomas before age 60 should
have a colonoscopy every five years beginning at age 40, according
to the guidelines.
However, screening recommendations for second- and third-degree
relatives of people diagnosed before age 60 are the same as for the
So, the new findings "raise the issue of whether some level of
more aggressive screening should be considered, not only for
first-degree relatives of patients with polyps diagnosed at or
below age 60, but also for those first-degree relatives of patients
diagnosed above age 60," Samadder said.
One expert not connected to the study said the findings may be
important, but it's often difficult to assess a patient's family
history when it comes to colon cancer.
"This information is important not only to specialists who treat colon and rectal and cancer but all primary care providers who recommend screening programs for their patients," said Dr. Jerald Wishner, director of colorectal surgery at Northern Westchester Hospital in Mount KIsco, NY.
However, he added that, "It will be difficult to apply this
information in everyday clinical practice. I regularly see patients
who know their relatives have had surgery for cancer don't know the
type. Finding out if their relatives have had adenomas or advanced
adenomas will be very difficult. This will be further complicated
as we seek information about second or third degree relatives."
The U.S. National Cancer Institute has more about
colorectal cancer screening.
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