title: Colonoscopy for screening and follow up of patients with a family history of colorectal cancer.
abstract: OBJECTIVE
  To determine the minimum family history of colorectal cancer (CRC), which justifies colonoscopy and to establish whether further colonic assessment is necessary after a negative screening colonoscopy.
  
  
  METHODS
  A retrospective review of every colonoscopy undertaken for family screening at the Royal Berkshire and Battle Hospitals, Reading between October 1996 and July 2004.
  
  
  RESULTS
  Four hundred and thirty-two patients (261 women) with an average age of 48 years (range 14-84) were screened. Three cancers in patients over the age of 60 years and 49 adenomas were found in 37 patients. Twenty three of 281 (8%) patients with a 'low-risk' family history (one in 12 or less lifetime risk of developing CRC) had either a cancer or an adenoma. Eighteen of 151 (12%) patients with a 'high-risk' family history (one in 10 or greater) had a similar positive colonoscopy. Thirteen of 15 patients who had an adenoma aged under 45 years had a high-risk family history. Seventy-three patients subsequently underwent two or more follow-up colonoscopies. There were 22 adenomatous polyps found in 12 patients (16%) at the first screening, nine adenomas in seven patients in the second colonoscopy and four adenomas found in four patients in all subsequent colonoscopies.
  
  
  CONCLUSIONS
  Patients with a low-risk family history have a similar adenoma pick-up to that of the general population. These patients need not be screened below the age of 50 unless symptomatic. Follow up of low-risk family history (FH) patients with a negative screening colonoscopy is unlikely to be beneficial.
authors.affiliation: Royal Berkshire Hospital, Reading, Berkshire, UK.
authors.forename: M G
authors.initials: MG
authors.lastname: Tytherleigh
authors.forename: V V
authors.initials: VV
authors.lastname: Ng
authors.forename: L O
authors.initials: LO
authors.lastname: Mathew
authors.forename: T
authors.initials: T
authors.lastname: Banerjee
authors.forename: K V
authors.initials: KV
authors.lastname: Menon
authors.forename: A S
authors.initials: AS
authors.lastname: Mee
authors.forename: R
authors.initials: R
authors.lastname: Farouk
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000235:genetics; D018256:Adenomatous Polyps / Q000175:diagnosis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies