Familial component of early-onset colorectal cancer: opportunity for prevention.

Humans Middle Aged Colorectal Neoplasms / diagnosis Colonoscopy Endoscopy, Gastrointestinal

Journal

The British journal of surgery

ISSN: 1365-2168

Titre abrégé: Br J Surg

Pays: England

ID NLM: 0372553

Informations de publication

Date de publication:
22 11 2022

Historique:

received: 15 06 2022

revised: 17 08 2022

accepted: 21 08 2022

pubmed: 16 9 2022

medline: 31 12 2022

entrez: 15 9 2022

Statut: ppublish

Résumé

Individuals with a non-syndromic family history of colorectal cancer are known to have an increased risk. There is an opportunity to prevent early-onset colorectal cancer (age less than 50 years) (EOCRC) in this population. The aim was to explore the proportion of EOCRC that is preventable due to family history of colorectal cancer. This was a retrospective multicentre European study of patients with non-hereditary EOCRC. The impact of the European Society of Gastrointestinal Endoscopy (ESGE), U.S. Multi-Society Task Force (USMSTF), and National Comprehensive Cancer Network (NCCN) guidelines on prevention and early diagnosis was compared. Colorectal cancer was defined as potentially preventable if surveillance colonoscopy would have been performed at least 5 years before the age of diagnosis of colorectal cancer, and diagnosed early if colonoscopy was undertaken between 1 and 4 years before the diagnosis. Some 903 patients with EOCRC were included. Criteria for familial colorectal cancer risk in ESGE, USMSTF, and NCCN guidelines were met in 6.3, 9.4, and 30.4 per cent of patients respectively. Based on ESGE, USMSTF, and NCCN guidelines, colorectal cancer could potentially have been prevented in 41, 55, and 30.3 per cent of patients, and diagnosed earlier in 11, 14, and 21.1 per cent respectively. In ESGE guidelines, if surveillance had started 10 years before the youngest relative, there would be a significant increase in prevention (41 versus 55 per cent; P = 0.010). ESGE, USMSTF, and NCCN criteria for familial colorectal cancer were met in 6.3, 9.4, and 30.4 per cent of patients with EOCRC respectively. In these patients, early detection and/or prevention could be achieved in 52, 70, and 51.4 per cent respectively. Early and accurate identification of familial colorectal cancer risk and increase in the uptake of early colonoscopy are key to decreasing familial EOCRC.

Sections du résumé

BACKGROUND

METHODS

This was a retrospective multicentre European study of patients with non-hereditary EOCRC. The impact of the European Society of Gastrointestinal Endoscopy (ESGE), U.S. Multi-Society Task Force (USMSTF), and National Comprehensive Cancer Network (NCCN) guidelines on prevention and early diagnosis was compared. Colorectal cancer was defined as potentially preventable if surveillance colonoscopy would have been performed at least 5 years before the age of diagnosis of colorectal cancer, and diagnosed early if colonoscopy was undertaken between 1 and 4 years before the diagnosis.

RESULTS

Some 903 patients with EOCRC were included. Criteria for familial colorectal cancer risk in ESGE, USMSTF, and NCCN guidelines were met in 6.3, 9.4, and 30.4 per cent of patients respectively. Based on ESGE, USMSTF, and NCCN guidelines, colorectal cancer could potentially have been prevented in 41, 55, and 30.3 per cent of patients, and diagnosed earlier in 11, 14, and 21.1 per cent respectively. In ESGE guidelines, if surveillance had started 10 years before the youngest relative, there would be a significant increase in prevention (41 versus 55 per cent; P = 0.010).

CONCLUSION

ESGE, USMSTF, and NCCN criteria for familial colorectal cancer were met in 6.3, 9.4, and 30.4 per cent of patients with EOCRC respectively. In these patients, early detection and/or prevention could be achieved in 52, 70, and 51.4 per cent respectively. Early and accurate identification of familial colorectal cancer risk and increase in the uptake of early colonoscopy are key to decreasing familial EOCRC.

Identifiants

DOI: 10.1093/bjs/znac322 PMID: 36108087

pubmed: 36108087

pii: 6701677

doi: 10.1093/bjs/znac322

doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

1319-1325

Subventions

Organisme : Generalitat de Catalunya

Organisme : Instituto de Salud Carlos III

Organisme : Agència de Gestió d'Ajuts Universitaris i de Recerca

Organisme : European Regional Development Fund

Investigateurs

A C Santos (AC)

M Martínez (M)

V Moreno (V)

Jose Carlos J C Ruffinelli (JCJC)

L Inglada-Pérez (L)

J Rueda (J)

V Castellano (V)

S Hernández-Villafranca (S)

M Escanciano (M)

A Cavero (A)

V Portugal (V)

M Domenech (M)

L Jiménez (L)

I Peligros (I)

C Rey (C)

J Zorrilla (J)

M Cuatrecasas (M)

A Sánchez (A)

L Rivero-Sanchez (L)

M Iglesias (M)

A Ramírez de Molina (AR)

G Colmenarejo (G)

I Espinosa-Salinas (I)

L Fernández (L)

M Gómez de Cedrón (MG)

L Corchete (L)

J L García (JL)

P García (P)

A Hernández (A)

A Martel (A)

J Pérez (J)

A Burdaspal (A)

M de Fuenmayor (M)

A Forero (A)

I Rubio (I)

J Fernández (J)

E Pastor (E)

A Villafañe (A)

O Alonso (O)

S Encinas (S)

A Teijo (A)

C Pastor (C)

J Arredondo (J)

J Baixauli (J)

L Ceniceros (L)

J Rodriguez (J)

C Sánchez (C)

J Die (J)

J Fernández (J)

J Ocaña (J)

J Dziakova (J)

S Picazo (S)

R Sanz (R)

M Suárez (M)

J Alcazar (J)

J García (J)

M Urioste (M)

N Malats (N)

L Estudillo (L)

J Pérez-Pérez (J)

E Espín (E)

F Marinello (F)

M Kraft (M)

S Landolfi (S)

B Pares (B)

M Verdaguer (M)

I Valverde (I)

C Narváez (C)

K Borycka (K)

R Gellert (R)

D Kołacin (D)

B Ziółkowski (B)

H Curley (H)

I Tomlinson (I)

C Foppa (C)

A Maroli (A)

M Abdulrahman (M)

M Nielsen (M)

J Azagra (J)

B Pascotto (B)

M Ali (M)

C Anele (C)

O Faiz (O)

M Uryszek (M)

R Aseem (R)

N Pawa (N)