Calculating the Starting Age for Screening in Relatives of Patients With Colorectal Cancer Based on Data From Large Nationwide Data Sets.
Adult
Age Factors
Aged
Aged, 80 and over
Colonoscopy
/ standards
Colorectal Neoplasms
/ diagnosis
Datasets as Topic
Early Detection of Cancer
/ standards
Female
Follow-Up Studies
Humans
Male
Mass Screening
/ standards
Medical History Taking
Middle Aged
Practice Guidelines as Topic
Registries
/ statistics & numerical data
Risk Assessment
/ statistics & numerical data
Risk Factors
Sweden
/ epidemiology
Colon
Familial
Inherited
Rectal
Journal
Gastroenterology
ISSN: 1528-0012
Titre abrégé: Gastroenterology
Pays: United States
ID NLM: 0374630
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
30
09
2019
revised:
17
02
2020
accepted:
24
03
2020
pubmed:
7
4
2020
medline:
1
4
2021
entrez:
7
4
2020
Statut:
ppublish
Résumé
Although colorectal cancer (CRC) screening guidelines acknowledge the need for earlier screening for high-risk individuals, such as those with family history of CRC, there is limited information on how many years earlier these high-risk individuals should be screened; current practice is based on weak evidence. We aimed to provide risk-adapted recommendations on the starting age of CRC screening for individuals with different family histories. We collected data from nationwide family-cancer data sets in Sweden and calculated risk-adapted starting ages of screening for individuals with different family histories of CRC. Family history was defined as a dynamic (time-dependent) variable, allowing for changes during the follow-up period of 1958 through 2015. During a follow-up of 12,829,251 individuals with genealogy information, 173,796 developed CRC. The 10-year cumulative risk for the average-risk population at age 50 years (the guideline-recommended age for screening) was 0.44%. Individuals with different family histories of CRC attained this equivalent 0.44% risk 3-29 years earlier than their peers in the general population without such a family history. For example, individuals with 1 affected first-degree relative diagnosed before age 45 years reached the corresponding risk level 16 years earlier. We determined risk-adapted starting ages of CRC screening for close or distant relatives of patients with CRC, using high quality nationwide data sets. These findings might be used in counselling individuals about the appropriate age to start CRC screening, to optimize screening practice, and to supplement guidelines for CRC screening.
Sections du résumé
BACKGROUND & AIMS
Although colorectal cancer (CRC) screening guidelines acknowledge the need for earlier screening for high-risk individuals, such as those with family history of CRC, there is limited information on how many years earlier these high-risk individuals should be screened; current practice is based on weak evidence. We aimed to provide risk-adapted recommendations on the starting age of CRC screening for individuals with different family histories.
METHODS
We collected data from nationwide family-cancer data sets in Sweden and calculated risk-adapted starting ages of screening for individuals with different family histories of CRC. Family history was defined as a dynamic (time-dependent) variable, allowing for changes during the follow-up period of 1958 through 2015.
RESULTS
During a follow-up of 12,829,251 individuals with genealogy information, 173,796 developed CRC. The 10-year cumulative risk for the average-risk population at age 50 years (the guideline-recommended age for screening) was 0.44%. Individuals with different family histories of CRC attained this equivalent 0.44% risk 3-29 years earlier than their peers in the general population without such a family history. For example, individuals with 1 affected first-degree relative diagnosed before age 45 years reached the corresponding risk level 16 years earlier.
CONCLUSIONS
We determined risk-adapted starting ages of CRC screening for close or distant relatives of patients with CRC, using high quality nationwide data sets. These findings might be used in counselling individuals about the appropriate age to start CRC screening, to optimize screening practice, and to supplement guidelines for CRC screening.
Identifiants
pubmed: 32251666
pii: S0016-5085(20)30446-7
doi: 10.1053/j.gastro.2020.03.063
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
159-168.e3Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.