title: Screening reduces colorectal cancer rate in families with hereditary nonpolyposis colorectal cancer.
abstract: OBJECTIVE
  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.
authors.affiliation: Second Department of Surgery, Helsinki University Central Hospital, Finland.
authors.forename: H J
authors.initials: HJ
authors.lastname: Järvinen
authors.forename: J P
authors.initials: JP
authors.lastname: Mecklin
authors.forename: P
authors.initials: P
authors.lastname: Sistonen
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000453:epidemiology / Q000517:prevention & control*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate