Feasibility study of colonoscopy as the primary screening investigation in relatives of patients with colorectal cancer.
OBJECTIVE
Relatives of patients with colorectal cancer are thought to be at a higher risk for this disease than the average population. We aimed to determine whether colonoscopy is a feasible primary screening investigation for this group to identify premalignant and malignant lesions.


METHODS
A total of 449 people underwent colonoscopy and all had one or more relatives with colorectal cancer, of these, 212 were classified as 'asymptomatic' and 237 as being 'symptomatic'. Colonoscopy commenced at 40 years of age or 10 years younger than the youngest affected relative.


RESULTS
Neoplastic change, benign and malignant, was found in 25.5% of the 'asymptomatic' group and 24% of the 'symptomatic' group; in 26% of those with one first degree relative, 39% with two or more first degree relatives and only 19% with second degree relatives. 38% of lesions were out of reach of a flexible sigmoidoscope. No known complications occurred.


CONCLUSIONS
It is feasible to perform colonoscopy as the primary investigation for the first degree relatives of patients with colorectal cancer. The yield of neoplastic lesions is sufficient to make this appropriate.
Gilbert
J M
JM
Department of Surgery, Wexham Park Hospital, Slough, Berkshire, UK.
Vaizey
C J
CJ
Cassell
P G
PG
Holden
J
J
D000236:Adenoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D004739:England; D005190:Family; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009386:Neoplastic Syndromes, Hereditary / Q000175:diagnosis* / Q000473:pathology