Identification of familial colorectal cancer and hereditary colorectal cancer syndromes through the Dutch population-screening program: results ofa pilot study.
In 2014, a population-screening program using immuno-faecal occult blood testing (I-FOBT) has started in the Netherlands. The aims of this study were to evaluate the proportion of individuals in the Dutch screening program with a positive I-FOBT that fulfill the criteria for familial colorectal cancer (FCC) and to evaluate the proportion of participants that needs genetic counseling or colonoscopic surveillance.



This retrospective observational study was performed in two large hospitals. Individuals aged between 55 and 75 years with a positive I-FOBT that underwent colonoscopy were included. A detailed family history was obtained in all individuals.



A total of 657 individuals with a positive I-FOBT test underwent colonoscopy. A total of 120 (18.3%) participants were found to have a positive family history for CRC, 20 (3.0%) fulfilled the FCC criteria, 4 (0.6%) the Bethesda guidelines and 1 (0.2%) participant the Amsterdam criteria. Multiple adenomas (>10) were found in 21 (3.2%) participants. No cases of serrated polyposis were identified. Based on these criteria and guidelines, a total of 35 (5.3%) required referral to the clinical geneticist and the relatives of 20 (3.0%) participants should be referred for surveillance colonoscopy.



Obtaining a detailed family history at the time of intake of participants with a positive I-FOBT in the Dutch surveillance program increased the identification of participants with familial CRC.
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
Sanne J H
SJ
van Erp
b Department of Gastroenterology & Hepatology , Isala Clinics , Zwolle , the Netherlands ;
Laura W
LW
Leicher
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
Simone D
SD
Hennink
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
Zeinab
Z
Ghorbanoghli
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
Simone A C
SA
Breg
c Department of Pathology , Leiden University Medical Center , Leiden , the Netherlands ;
Hans
H
Morreau
d Department of Clinical Genetics , Leiden University Medical Center , Leiden , the Netherlands ;
Maartje
M
Nielsen
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
James C H
JC
Hardwick
e Department of Surgery , Elisabeth Hospital , Tilburg , the Netherlands ;
Jan A
JA
Roukema
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;
Alexandra M J
AM
Langers
b Department of Gastroenterology & Hepatology , Isala Clinics , Zwolle , the Netherlands ;
Wouter H
WH
de Vos Tot Nederveen Cappel
a Department of Gastroenterology & Hepatology , Leiden University Medical Center , Leiden , the Netherlands ;|f The Netherlands Foundation for the Detection of Hereditary Tumors , Leiden , the Netherlands.
Hans F A
HF
Vasen
D000236:Adenoma / Q000453:epidemiology*; D000368:Aged; D003113:Colonoscopy; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis* / Q000453:epidemiology*; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009426:Netherlands; D009780:Occult Blood; D010865:Pilot Projects; D011159:Population Surveillance; D012017:Referral and Consultation; D012189:Retrospective Studies
Colorectal cancer; familial colorectal cancer; genetic counseling; immuno-faecal occult blood testing; screening program; surveillance