Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study

Int J Colorectal Dis. 2006 May;21(4):301-7. doi: 10.1007/s00384-005-0032-2. Epub 2005 Sep 15.


Background and aims: Persons with a familial risk of colorectal cancer (CRC) account for about 25% of all CRC cases. The adenoma prevalence in relatives of CRC patients 50-60 years of age is 17-34%; data on younger individuals are scarce. Our aim was to prospectively define the adenoma prevalence in 40- to 50-year-old first-degree relatives of CRC patients compared to controls.

Patients and methods: CRC patients were identified via the regional cancer registry, and their 40- to 50-year-old first-degree relatives (risk group) were invited for screening colonoscopy. Additional probands and controls of the same age were recruited by newspaper articles and radio or television broadcastings. Using high-resolution video colonoscopy, each detected polyp was removed and histopathologically assessed. Each participant completed demographic and epidemiological questionnaires.

Results: Of 228 subjects in the risk group 36.4% had polypoid lesions compared to 20.9% of 220 controls (p<0.001). Forty-three (18.9%) subjects in the risk group had adenomas compared to 18 (8.2%) in the control group (p=0.001). High-risk adenomas (>10 mm and/or of villous type) were found in 12 persons in the risk group compared to 5 controls (not significant). In the risk group most lesions (52%) were located proximal to the sigmoid colon compared to 29% in controls.

Conclusions: Subjects between 40-50 years with first-degree relatives with CRC demonstrate a significantly higher prevalence of adenomas than controls, with a tendency towards a more proximal location. These data support a screening colonoscopy in persons with familial risk already between 40 and 50 years.

Publication types

  • Multicenter Study

MeSH terms

  • Adenomatous Polyps / epidemiology*
  • Adult
  • Age Distribution
  • Case-Control Studies
  • Colonic Polyps / epidemiology*
  • Colonoscopy*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / prevention & control*
  • Female
  • Genetic Predisposition to Disease
  • Germany / epidemiology
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Registries
  • Sex Distribution