title: Colonoscopic surveillance of first-degree relatives of colorectal cancer patients in a faecal occult blood screening programme.
abstract: BACKGROUND
  In some Italian areas, colonoscopic surveillance of first-degree relatives (FDRs) of colorectal cancer (CRC) patients is provided as a part of local population-based faecal occult blood test (FOBT) screening programmes. The objective of the present study was to assess the feasibility and early results of this surveillance model.
  
  
  METHODS
  Data from district screening centres were used to evaluate the process of identification and selection of eligible FDRs (residence in the Emilia-Romagna Region, age 40-75 years, no recent colonoscopy) of screen-detected CRC patients and the detected prevalence of disease. The probability for an FDR to undergo colonoscopy and to be diagnosed with CRC and advanced adenoma was estimated using the Kaplan-Meier method. The sex- and age-standardised ratio of detected prevalence to that expected based on results from a colonoscopy screening study of the Italian general population was estimated.
  
  
  RESULTS
  Between 2005 and 2011, 9319 FDRs of 2437 screen-detected CRC patients (3.8 per patient) were identified and contacted. Their likelihood of being eligible for, and accepting, colonoscopy was 0.11 (95% confidence interval: 0.11-0.12). Among the 926 subjects undergoing colonoscopy, the prevalence of previous negative screening FOBT was 63%. Eleven CRCs (1.2%) and 100 advanced adenomas (10.8%) were detected. The standardised ratio of detected prevalence to that expected was 0.91 (95% confidence interval: 0.19-2.66) for CRC and 1.48 (1.04-2.05) for advanced adenoma.
  
  
  CONCLUSIONS
  The procedure of selection of FDRs was extremely ineffective. Due to previous negative screening tests, the prevalence of disease was less than expected. A population-based FOBT screening programme is a highly unsuitable setting for the provision of surveillance to FDRs of CRC patients.
authors.affiliation: Department of Health, Emilia-Romagna Region, 40127 Bologna, Italy.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Sassoli de Bianchi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Campari
authors.forename: Silvia
authors.initials: S
authors.lastname: Mancini
authors.forename: Orietta
authors.initials: O
authors.lastname: Giuliani
authors.forename: Patrizia
authors.initials: P
authors.lastname: Landi
authors.forename: Luisa
authors.initials: L
authors.lastname: Paterlini
authors.forename: Carlo
authors.initials: C
authors.lastname: Naldoni
authors.forename: Alba C
authors.initials: AC
authors.lastname: Finarelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ponz de Leon
authors.forename: Romano
authors.initials: R
authors.lastname: Sassatelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Borciani
authors.forename: Fabio
authors.initials: F
authors.lastname: Fornari
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gatti
authors.forename: Marella
authors.initials: M
authors.lastname: Zatelli
authors.forename: Corrado
authors.initials: C
authors.lastname: Zurlini
authors.forename: Federica
authors.initials: F
authors.lastname: Rossi
authors.forename: Rossella
authors.initials: R
authors.lastname: Corradini
authors.forename: Rossella
authors.initials: R
authors.lastname: Olivetti
authors.forename: Marilena
authors.initials: M
authors.lastname: Manfredi
authors.forename: Paola
authors.initials: P
authors.lastname: Baldazzi
authors.forename: Roberto
authors.initials: R
authors.lastname: Nannini
authors.forename: Stefano
authors.initials: S
authors.lastname: Zanarini
authors.forename: Vincenzo G
authors.initials: VG
authors.lastname: Matarese
authors.forename: Caterina
authors.initials: C
authors.lastname: Palmonari
authors.forename: Omero
authors.initials: O
authors.lastname: Triossi
authors.forename: Sonia
authors.initials: S
authors.lastname: Gordini
authors.forename: Rosa
authors.initials: R
authors.lastname: Vattiato
authors.forename: Americo
authors.initials: A
authors.lastname: Colamartini
authors.forename: Mauro
authors.initials: M
authors.lastname: Palazzi
authors.forename: Mirna
authors.initials: M
authors.lastname: Severi
authors.forename: Laura
authors.initials: L
authors.lastname: Briganti
authors.forename: Mauro
authors.initials: M
authors.lastname: Giovanardi
authors.forename: Coralba
authors.initials: C
authors.lastname: Casale
authors.forename: Lauro
authors.initials: L
authors.lastname: Bucchi
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005192:Family Health; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D015995:Prevalence