title: Advanced colonic neoplasia in the first degree relatives of colon cancer patients: A colonoscopy-based study.
abstract: We aimed to determine the risk of advanced neoplasms among a cohort of asymptomatic first degree relatives (FDRs) of patients with sporadic colorectal cancer (CRC) compared with matched controls. Data for patients with a diagnosis of CRC made between September 2013 and August 2014 were obtained from a population-based cancer registry system in Tehran. Screening colonoscopies were done for 342 FDRs and the findings were compared to those from 342 age- and gender-matched healthy controls without a family history of CRC. We reported the association as conditional Odds Ratio (OR) using Mantel Hazel and Logistic regression. The prevalence of advanced neoplasia was 13.2% among FDRs and 3.8% in controls (matched OR [mOR], 4.0, 95% confidence interval [CI], 2.1 - 7.6; p < 0.001). In FDRs aged 40-49 years, the prevalence of advanced neoplasia was significantly higher than in their matched controls (mOR, 6.8, 95% CI, 1.5-31.4; p = 0.01). Family history of CRC in at least one FDR was the strongest predictor of advanced neoplasia (adjusted OR, 4.0, 95% CI: 2.1-7.6; p < 0.001). The age of the index case at diagnosis did not predict the presence of advanced colonic neoplasms in their FDRs. Our study indicates a high risk of advanced neoplasia in FDRs of CRC cases, where only eight colonoscopies are needed to detect one advanced neoplasia. Our data suggest that all FDRs, regardless of the age of CRC diagnosis in their index case, should be considered for a targeted early screening.
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hamideh
authors.identifier: 0000-0001-6471-0069
authors.initials: H
authors.lastname: Salimzadeh
authors.affiliation: Masoud Gastroenterology and Hepatology Clinic, Sasan Alborz Biomedical Research Center, Tehran, Iran. faraz_bishehsari@rush.edu.|Department of Internal Medicine, Division of Gastroenterology, Rush University Medical Center, Chicago, IL. faraz_bishehsari@rush.edu.
authors.forename: Faraz
authors.initials: F
authors.lastname: Bishehsari
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Amani
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Ansari
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.|Masoud Gastroenterology and Hepatology Clinic, Sasan Alborz Biomedical Research Center, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Sotoudeh
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. delavari@tums.ac.ir.
authors.forename: Alireza
authors.initials: A
authors.lastname: Delavari
authors.affiliation: Digestive Oncology Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.|Masoud Gastroenterology and Hepatology Clinic, Sasan Alborz Biomedical Research Center, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D003113:Colonoscopy / Q000379:methods*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: colorectal cancer screening; colorectal neoplasia; family cancer