Screening Reduces Colorectal Cancer Rate in Families With Hereditary Nonpolyposis Colorectal Cancer

Gastroenterology. 1995 May;108(5):1405-11. doi: 10.1016/0016-5085(95)90688-6.

Abstract

Background/aims: The inherited susceptibility to hereditary nonpolyposis colorectal cancer (HNPCC) provides an opportunity for secondary prevention of colorectal cancer (CRC) in family members who are at 50% lifetime risk. The aim of this study was to evaluate the effectiveness of long-term screening during a 10-year period.

Methods: The CRC and death rates were compared between two groups of asymptomatic at-risk members of 22 families with HNPCC: 133 subjects screened at 3-year intervals by colonoscopy or barium enema and sigmoidoscopy and 118 control subjects without screening. The screening was complete in 118 subjects (89%), whereas 18 control subjects (15%) had screening examinations outside of the study.

Results: CRC occurred in 6 study subjects (4.5%) and in 14 controls (11.9%; P = 0.03), a difference of 7.4% in favor of the study group, which corresponds to a reduction by 62% that is presumably because of polypectomies. The tumor stage was more favorable in the screening group with no deaths caused by CRC compared with 5 of 14 cases in controls. Overall, there were 6 and 12 deaths within the 10-year period in the study and control groups, respectively (P = 0.08).

Conclusions: The 3-year interval screening more than halves the CRC rate in at-risk members of families with HNPCC and seems to prevent CRC deaths.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Colorectal Neoplasms, Hereditary Nonpolyposis / epidemiology
  • Colorectal Neoplasms, Hereditary Nonpolyposis / prevention & control*
  • Family Health*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Mass Screening*
  • Middle Aged
  • Program Evaluation
  • Prospective Studies
  • Risk Factors
  • Survival Rate