title: Risk of Colorectal Neoplasia in Individuals With Self-Reported Family History: A Prospective Colonoscopy Study from 16 Asia-Pacific Regions.
abstract: We tested the hypothesis that the risk of colorectal cancer (CRC), advanced colorectal neoplasia (ACN), and colorectal adenoma among screening participants with different first-degree relatives (FDRs) affected by CRC was similar.
  
  
  
  A multi-center, prospective colonoscopy study involving 16 Asia-Pacific regions was performed from 2008 to 2015. Consecutive self-referred CRC screening participants aged 40-70 years were recruited, and each subject received one direct optical colonoscopy. The prevalence of CRC, ACN, and colorectal adenoma was compared among subjects with different FDRs affected using Pearson's χ2tests. Binary logistic regression analyses were performed to evaluate the risk of these lesions, controlling for recognized risk factors including age, gender, smoking habits, alcohol drinking, body mass index, and the presence of diabetes mellitus.
  
  
  
  Among 11,797 asymptomatic subjects, the prevalence of CRC was 0.6% (none: 0.6%; siblings: 1.1%; mother: 0.5%; father: 1.2%; ≥2 members: 3.1%, P<0.001), that of ACN was 6.5% (none: 6.1%; siblings: 8.3%; mother: 7.7%; father: 8.7%; ≥2 members: 9.3%, P<0.001), and that of colorectal adenoma was 29.3% (none: 28.6%; siblings: 33.5%; mother: 31.8%; father: 31.1%; ≥2 members: 38.1%, P<0.001). In multivariate regression analyses, subjects with at least one FDR affected were significantly more likely to have CRC (adjusted odds ratio (AOR)=2.02-7.89), ACN (AOR=1.55-2.06), and colorectal adenoma (AOR=1.31-1.92) than those without a family history. The risk of CRC (AOR=0.90, 95% confidence interval (CI) 0.34-2.35, P=0.830), ACN (AOR=1.07, 95% CI 0.75-1.52, P=0.714), and colorectal adenoma (AOR=0.96, 95% CI 0.78-1.19, P=0.718) in subjects with either parent affected was similar to that of subjects with their siblings affected.
  
  
  
  The risk of colorectal neoplasia was similar among subjects with different FDRs affected. These findings do not support the need to discriminate proband identity in screening participants with affected FDRs when their risks of colorectal neoplasia were estimated.
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.|Faculty of Medicine, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jessica Y L
authors.initials: JY
authors.lastname: Ching
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Han-Mo
authors.initials: HM
authors.lastname: Chiu
authors.affiliation: Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
authors.forename: Kai Chun
authors.initials: KC
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Rungsun
authors.initials: R
authors.lastname: Rerknimitr
authors.affiliation: Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jingnan
authors.initials: J
authors.lastname: Li
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Deng-Chiang
authors.initials: DC
authors.lastname: Wu
authors.affiliation: Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Khean Lee
authors.initials: KL
authors.lastname: Goh
authors.affiliation: Division of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Hyun-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Bankstown and Concord Hospitals, Sydney, New South Wales, Australia.
authors.forename: Rupert
authors.initials: R
authors.lastname: Leong
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Khay Guan
authors.initials: KG
authors.lastname: Yeoh
authors.affiliation: Division of Gastroenterology, RIPAS Hospital, Brunei, Darussalam.
authors.forename: Vui Heng
authors.initials: VH
authors.lastname: Chong
authors.affiliation: Section of Gastroenterology, University of Santo Tomas Hospital, Manila, Philippines.
authors.forename: Jose D
authors.initials: JD
authors.lastname: Sollano
authors.affiliation: Division of Gastroenterology, Aga Khan University, Karachi, Pakistan.
authors.forename: Furqaan
authors.initials: F
authors.lastname: Ahmed
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia.
authors.forename: Jayaram
authors.initials: J
authors.lastname: Menon
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Siew C
authors.initials: SC
authors.lastname: Ng
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Justin C Y
authors.initials: JC
authors.lastname: Wu
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Francis K L
authors.initials: FK
authors.lastname: Chan
authors.affiliation: CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Joseph J Y
authors.initials: JJ
authors.lastname: Sung
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010290:Parents; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D057566:Self Report; D035781:Siblings; D012907:Smoking / Q000453:epidemiology