Risk of colorectal adenomas in patients with a family history of colorectal cancer: some implications for screening programmes.
OBJECTIVE
Most colorectal cancers (CRC) arise in colorectal adenomas. A case-control study was conducted to see whether a family history of CRC is associated with a higher prevalence of colorectal adenomas.


METHODS
Subjects were drawn from all patients who underwent colonoscopy at the Royal Brisbane Hospital between 1980-1982 and 1985, and included 141 cases with colorectal adenomas diagnosed at colonoscopy and 882 controls who were free of polyps at colonoscopy.


METHODS
The prevalence of family history of CRC was compared between patients with adenomas and negative colonoscopy controls.


RESULTS
Overall, patients with one first degree relative with CRC were at no greater risk for adenomas at colonoscopy than patients with no family history (odds ratio (OR) = 0.8, 95% confidence intervals (CI) = 0.4, 1.5). Patients with two or more affected first degree relatives had a more than doubled risk for adenomas (OR = 2.3, 95% CI = 0.5, 8.2), and were also more likely to carry moderately or severely dysplastic adenomas (OR = 14.1, 95% CI = 2.0, 62.9).


CONCLUSIONS
These findings are consistent with the hypothesis that some families, in addition to those with familial adenomatous polyposis, have an increased susceptibility to develop colorectal adenomas, and that adenomas in such families may have a greater tendency to undergo malignant transformation.
Aitken
J F
JF
Department of Social and Preventive Medicine, University of Queensland, Brisbane.
Bain
C J
CJ
Ward
M
M
Siskind
V
V
MacLennan
R
R
D000236:Adenoma / Q000453:epidemiology / Q000235:genetics*; D000328:Adult; D016022:Case-Control Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010375:Pedigree; D015995:Prevalence; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors