Earlier Screening for Colorectal Cancer Based on Family History
Posted: Thursday, May 21, 2020
Family history–based screening guidelines may lead to an earlier diagnosis of colorectal cancer in patients younger than 50 years old, according to a population-based study of more than 3,000 people published in Cancer. “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 health-care providers more consistently elicit and act on family history,” said Samir Gupta, MD, MDCS, AGAF, of the VA San Diego Healthcare System and the University of California at San Diego, in a press release.
From 1998 to 2007, 3,245 patients with (n = 2,473) and without (n = 772) incidence of colorectal cancer were enrolled in the study. All patients were between 40 and 49 years of age and were enrolled in the Colon Cancer Family Registry. Dr. Gupta and colleagues aimed to determine the specificity and sensitivity of family history–based guidelines for earlier screening and the age each participant should have been recommended for colorectal cancer screening based on these criteria. Guidelines from the American Cancer Society, U.S. Multi-Society Task Force, and American College of Radiology were included, because these organizations also provided recommendations for early screening.
The investigators found that family history–based guidelines had a sensitivity of 25% and a specificity of 90% for recognizing individuals with colorectal cancer. Additionally, of these patients, 98.4% could have been diagnosed earlier had the family history–based guidelines been applied to these individuals, they proposed. In fact, the mean age of diagnosis could have been 10 years younger than the observed diagnostic age. These findings provide the opportunity to establish more strategies to easily identify early-onset colorectal cancer in younger patients.
Disclosure: For full disclosures of the authors, visit wiley.com.