The role of colonoscopy in screening persons with family history of colorectal cancer.
First-degree relatives of colorectal cancer patients are at increased risk for developing colorectal neoplasms. In order to assess the potentiality of colonoscopy screening in this high-risk population, 213 asymptomatic family members (age range 30-69 years, mean 42.8 years) of those patients with colorectal cancer received colonoscopic examination at Chang-Gung Memorial Hospital from April 1992 to May 1994. Twenty-eight persons with 42 lesions (polyps or cancer) were identified, including 28 adenomas, nine hyperplastic polyps and five adenocarcinomas. The positive detection rate was 9.9% for adenoma and 2.3% for cancer. Colorectal neoplasms afflicted males more frequently than females (16.7 vs 5.7%, P < 0.05) and occurred less frequently in those < 40 years of age (5.5 vs 17.2%, P < 0.05). Forty-two per cent of the detected neoplastic lesions were beyond the reach of 60 cm flexible sigmoidoscopy and 36% of adenomas were < 0.5 cm in size and would be missed if patients were screened by air contrast barium enema. Cost analysis revealed that the charges of both screening colonoscopy and screening flexible sigmoidoscopy/air contrast barium enema were approximate. Colonoscopy also has a high acceptability and safety. It appears appropriate to use colonoscopy, rather than flexible sigmoidoscopy or air contrast barium enema, as an initial screening procedure for persons with a family history of colorectal cancer, especially those > 40 years of age.
Wu
C S
CS
Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
Tung
S Y
SY
Chen
P C
PC
Kuo
Y C
YC
D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003113:Colonoscopy / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003365:Costs and Cost Analysis; D004733:Enema / Q000191:economics; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D007417:Intestinal Polyps / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors; D012812:Sigmoidoscopy; D013624:Taiwan / Q000453:epidemiology
D001466:Barium Sulfate