Adding familial risk assessment to faecal occult blood test can increase the effectiveness of population-based colorectal cancer screening
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Publication year
2011Source
European Journal of Cancer, 47, 10, (2011), pp. 1571-7ISSN
Publication type
Article / Letter to editor
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Organization
IQ Healthcare
Human Genetics
Health Evidence
Gastroenterology
Medical Oncology
Former Organization
Epidemiology, Biostatistics & HTA
Journal title
European Journal of Cancer
Volume
vol. 47
Issue
iss. 10
Page start
p. 1571
Page end
p. 7
Subject
NCEBP 2: Evaluation of complex medical interventions; NCEBP 4: Quality of hospital and integrated care; NCEBP 4: Quality of hospital and integrated care ONCOL 4: Quality of Care; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 1: Hereditary cancer and cancer-related syndromes NCMLS 6: Genetics and epigenetic pathways of disease; ONCOL 3: Translational researchAbstract
BACKGROUND: The Dutch Health Council recently recommended the introduction of a colorectal cancer (CRC) screening programme by faecal occult blood testing (FOBT) for individuals aged 55-75 at population risk of CRC. Individuals at an increased familial CRC risk (>/= 2 times population risk) should be identified at a younger age, so they and their relatives can receive earlier, more intensive surveillance instead of FOBT. AIMS: To determine the percentage of participants with a positive FOBT in a CRC screening programme with an increased familial CRC risk. METHODS: In a population-based study, 10,569 individuals aged 50-75 received an FOBT. Individuals with a positive FOBT were invited for colonoscopy and familial risk assessment. Participants with an average familial CRC risk were compared to those with an increased risk. Increased familial CRC risk was defined as a cumulative lifetime risk of CRC of at least 10%. RESULTS: Of 6001 participants, 430 had a positive FOBT, of whom 324 (63% males; mean age 63 years) completed colonoscopy and familial risk assessment. CRC (n=22) and/or advanced adenomas (n=122) were found in 133 participants. Familial CRC risk was increased in 6% of participants with a positive FOBT. No significant differences were found between participants with an average versus an increased familial CRC risk. CONCLUSION: Six percent of participants with a positive FOBT had an increased familial CRC risk. Identifying at-risk participants enables them and their relatives to undergo regular colonoscopies. Adding familial risk assessment to FOBT screening may thus prevent a substantial number of CRCs.
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- Academic publications [238441]
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- Faculty of Medical Sciences [90373]
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