title: Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening program.
abstract: BACKGROUND
  A screening colonoscopy is recommended in first-degree relatives (FDRs) of colorectal cancer patients; few prospective, controlled studies have evaluated colorectal findings in a population-based screening program.
  
  
  OBJECTIVE
  To evaluate the prevalence of colorectal neoplasia (adenomas and adenocarcinomas) in this increased-risk population, to compare it with that of average-risk individuals, and to identify features that might allow risk stratification for neoplasia among FDRs.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Population-based screening program in Trentino, Italy.
  
  
  METHODS
  FDRs of colorectal cancer patients between 45 and 75 years of age with no history of hereditary colorectal cancer syndromes or inflammatory bowel disease.
  
  
  METHODS
  Average-risk individuals undergoing screening colonoscopy.
  
  
  METHODS
  Screening colonoscopy.
  
  
  RESULTS
  Neoplasia was found in 33.4% of 1252 FDRs and in 30.3% of 765 controls; advanced neoplasia was found in 11.3% of FDRs and in 6.3% of controls. Odds ratios (ORs) from the multivariate logistic regression analysis adjusted for age, sex, cecal intubation rates, and colon cleansing showed an increased risk of advanced neoplasia (OR 2.41; 95% CI, 1.69-3.43; P < .0001) in FDRs. Age older than 56 years (OR 1.83; 95% CI, 1.15-2.99; P = .013) and male sex (OR 2.17; 95% CI, 1.39-3.10; P < .001) are independent predictors of advanced neoplasia.
  
  
  CONCLUSIONS
  Italian subjects living in the same geographic area; of 4301 FDRs, 2521 were excluded.
  
  
  CONCLUSIONS
  The increased risk of advanced neoplasia supports the current recommendation for colonoscopic screening in this group; age and sex may assist in risk stratification of these individuals.
authors.affiliation: Department of Gastroenterology, Ospedale Santa Chiara, APSS, Trento, Italy. franco.armelao@apss.tn.it
authors.forename: Franco
authors.initials: F
authors.lastname: Armelao
authors.forename: Corrado
authors.initials: C
authors.lastname: Paternolli
authors.forename: Gaia
authors.initials: G
authors.lastname: Franceschini
authors.forename: Renzo
authors.initials: R
authors.lastname: Franch
authors.forename: Pier Giuseppe
authors.initials: PG
authors.lastname: Orlandi
authors.forename: Gianni
authors.initials: G
authors.lastname: Miori
authors.forename: Ivo
authors.initials: I
authors.lastname: Avancini
authors.forename: Michele
authors.initials: M
authors.lastname: Togni
authors.forename: Mauro
authors.initials: M
authors.lastname: Rossi
authors.forename: Alberto
authors.initials: A
authors.lastname: Meggio
authors.forename: Enrico
authors.initials: E
authors.lastname: Tasini
authors.forename: Romano
authors.initials: R
authors.lastname: Manfrini
authors.forename: Davide
authors.initials: D
authors.lastname: Giacomin
authors.forename: Renato
authors.initials: R
authors.lastname: Fasoli
authors.forename: Katia
authors.initials: K
authors.lastname: Faitini
authors.forename: Marina
authors.initials: M
authors.lastname: Mastromauro
authors.forename: Sirio
authors.initials: S
authors.lastname: Costa
authors.forename: Franco
authors.initials: F
authors.lastname: Ridolfi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rosi
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Pretis
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D000236:Adenoma / Q000453:epidemiology* / Q000473:pathology; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D010375:Pedigree; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors