Quantitative Assignment of Ages to Start Screening Based on Family History
Douglas K. Rex, MD, FASGE, reviewing Tian Y, et al. Gastroenterology 2020 Apr 3.
In a study from Sweden involving 12,829,251 persons who had family history information and were followed from 1958 to 2015, 173,796 developed colorectal cancer (CRC). The baseline linear cumulative risk for average-risk persons at age 50 was 0.44%. For various family histories, the researchers calculated the age at which to start screening based on equivalent risk, as outlined in the table below.
For example, for individuals with one first-degree relative with CRC diagnosed at age <45 years, the equivalent age to start screening would be 34 years.
COMMENTThe huge size of the study provides a remarkable opportunity to stratify risk quantitatively based on the number of first- or second-degree relatives with CRC and diagnosis age of the youngest affected relative. This is very useful quantitative information for creating screening recommendations based on family history.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Tian Y, Kharazmi E, Brenner H, et al. Calculating starting age for screening in relatives of patients with colorectal cancer based on data from large nationwide datasets. Gastroenterology 2020 Apr 3. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2020.03.063)
