Colonoscopy in asymptomatic individuals with a family history of colorectal cancer.
BACKGROUND
This study was performed to evaluate the use of total colonoscopy as the optimal screening test in asymptomatic individuals with a family history of colorectal cancer (CRC).


METHODS
Colonoscopy was performed in 249 asymptomatic individuals who had one or two first-degree relatives (FDRs) with CRC; individuals with three or more FDRs with CRC were excluded.


RESULTS
Eighty-six colonic lesions were found in 51 individuals (51 of 249; 20.5%). Among these 51 subjects, 27 had neoplastic polyps (n = 38) and 29 had metaplastic polyps (n = 44). Although no invasive cancer was detected, in 14 individuals the lesions had a high malignancy potential because of their size and histopathology. We did not confirm a statistically significant difference in the incidence of neoplastic polyps according to the number of affected FDRs. Finally, the presence of metaplastic polyps was a very strong indication for the concomitant presence of metaplastic polyps (P <.0001).


CONCLUSIONS
Total colonoscopy is the optimal screening procedure for the examination of asymptomatic individuals with a family history of CRC.
Syrigos
K N
KN
Department of Clinical Oncology, Imperial College of Science Technology and Medicine, Hammersmith Hospital Campus, London, UK. knsyrigos@usa.net
Charalampopoulos
A
A
Ho
J L
JL
Zbar
A
A
Murday
V A
VA
Leicester
R J
RJ
D000328:Adult; D000368:Aged; D003111:Colonic Polyps / Q000150:complications / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010375:Pedigree; D011237:Predictive Value of Tests