Adenomas as a risk factor in familial colorectal cancer: implications for screening and surveillance in the UK

Autor: Jmd Wheeler, Simon J.A. Buczacki
Rok vydání: 2016
Předmět:
Adenoma
Oncology
medicine.medical_specialty
Databases
Factual
Colorectal cancer
Adenomatous polyposis coli
Colonic Polyps
Colonoscopy
Risk Assessment
Gastroenterology
State Medicine
Familial adenomatous polyposis
03 medical and health sciences
0302 clinical medicine
Internal medicine
Humans
Medicine
Genetic Predisposition to Disease
Risk factor
Family history
Medical History Taking
Early Detection of Cancer
biology
medicine.diagnostic_test
business.industry
Carcinoma
Health Care Costs
Models
Theoretical
medicine.disease
Colorectal Neoplasms
Hereditary Nonpolyposis
United Kingdom
digestive system diseases
Lynch syndrome
Pedigree
Adenomatous Polyposis Coli
030220 oncology & carcinogenesis
Practice Guidelines as Topic
biology.protein
030211 gastroenterology & hepatology
Colorectal Neoplasms
business
Zdroj: Colorectal Disease. 18:842-845
ISSN: 1462-8910
Popis: Colorectal cancer (CRC) develops from normal epithelium, through dysplastic adenoma to invasive carcinoma. In addition to familial adenomatous polyposis and Lynch syndrome, approximately 10-35% of CRCs are familial in nature. CRC screening and surveillance programmes are based on an understanding of the natural history of polyps and rely on the ability to remove premalignant lesions endoscopically before they are capable of developing invasion. There are, however, significant differences in these guidelines between the UK and the USA in relation to the weight attributed to a family history of polyps. Here, using publicly available national data sets, we show that these differences in guidelines unexpectedly generate inadequate screening recommendations for second-degree relatives of patients with CRC in the UK. We validate our simple mathematical modelling of the clinical problem on a regional data set as well as previously published study data to demonstrate the correct interpretation. We further discuss the implications of a family history of adenoma formation in the current climate of the Bowel Cancer Screening Programme and suggest a re-evaluation of the UK guidelines in the light of this developing issue.
Databáze: OpenAIRE
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