Prospective colonoscopic study to investigate risk of colorectal neoplasms in first-degree relatives of patients with non-advanced adenomas

ObjectiveThe risk associated with a family history of non-advanced adenoma (non-AA) is unknown. We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas.DesignIn a blinded, cross-se...

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Veröffentlicht in:Gut 2020-02, Vol.69 (2), p.304-310
Hauptverfasser: Ng, Siew C, Kyaw, Moe Htet, Suen, Bing Yee, Tse, Yee Kit, Wong, Martin C S, Hui, Aric J, Tak, Hui Yee, Lau, James Y W, Sung, Joseph J Y, Chan, Francis K L
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container_end_page 310
container_issue 2
container_start_page 304
container_title Gut
container_volume 69
creator Ng, Siew C
Kyaw, Moe Htet
Suen, Bing Yee
Tse, Yee Kit
Wong, Martin C S
Hui, Aric J
Tak, Hui Yee
Lau, James Y W
Sung, Joseph J Y
Chan, Francis K L
description ObjectiveThe risk associated with a family history of non-advanced adenoma (non-AA) is unknown. We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas.DesignIn a blinded, cross-sectional study, consecutive subjects with newly diagnosed non-AA were identified from our colonoscopy database. 414 FDRs of subjects with non-AA (known as exposed FDRs; mean age 55.0±8.1 years) and 414 age and sex-matched FDRs of subjects with normal findings from colonoscopy (known as unexposed FDRs; mean age 55.2±7.8 years) underwent a colonoscopy from November 2015 to June 2018. One FDR per family was recruited. FDRs with a family history of colorectal cancer were excluded. The primary outcome was prevalence of advanced adenoma (AA). Secondary outcomes included prevalence of all adenomas and cancer.ResultsThe prevalence of AA was 3.9% in exposed FDRs and 2.4% in unexposed FDRs (matched OR (mOR)=1.67; 95% CI 0.72 to 3.91; p=0.238 adjusted for proband sex and proband age). Exposed FDRs had a higher prevalence of any adenomas (29.2% vs 18.6%; mOR=1.87; 95% CI 1.32 to 2.66; p
doi_str_mv 10.1136/gutjnl-2018-318117
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We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas.DesignIn a blinded, cross-sectional study, consecutive subjects with newly diagnosed non-AA were identified from our colonoscopy database. 414 FDRs of subjects with non-AA (known as exposed FDRs; mean age 55.0±8.1 years) and 414 age and sex-matched FDRs of subjects with normal findings from colonoscopy (known as unexposed FDRs; mean age 55.2±7.8 years) underwent a colonoscopy from November 2015 to June 2018. One FDR per family was recruited. FDRs with a family history of colorectal cancer were excluded. The primary outcome was prevalence of advanced adenoma (AA). Secondary outcomes included prevalence of all adenomas and cancer.ResultsThe prevalence of AA was 3.9% in exposed FDRs and 2.4% in unexposed FDRs (matched OR (mOR)=1.67; 95% CI 0.72 to 3.91; p=0.238 adjusted for proband sex and proband age). Exposed FDRs had a higher prevalence of any adenomas (29.2% vs 18.6%; mOR=1.87; 95% CI 1.32 to 2.66; p&lt;0.001) and non-AA (25.4% vs 16.2%; mOR=1.91; 95% CI 1.32 to 2.76; p=0.001). A higher proportion of exposed FDRs than unexposed FDRs (4.3% vs 2.2%; adjusted mOR=2.44; 95% CI 1.01 to 5.86; p=0.047) had multiple adenomas. No cancer was detected in both groups.ConclusionA positive family history of non-AA does not significantly increase the risk of clinically important colorectal neoplasia. The data support current guidelines which do not advocate earlier screening in individuals with a family history of non-AA.Trial registration number NCT0252172.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gutjnl-2018-318117</identifier><identifier>PMID: 31028155</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Adenoma ; Adenoma - epidemiology ; Adenoma - genetics ; Adult ; China - epidemiology ; Colon ; Colonoscopy ; colorectal adenomas ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - genetics ; Consent ; Cross-Sectional Studies ; Early Detection of Cancer ; Endoscopy ; family cancer ; Family medical history ; Female ; Genetic Predisposition to Disease ; Health risk assessment ; Histology ; Humans ; Male ; Middle Aged ; Patients ; Prevalence ; Prospective Studies ; Risk Assessment - methods ; Risk Factors ; Studies ; Tumors</subject><ispartof>Gut, 2020-02, Vol.69 (2), p.304-310</ispartof><rights>Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b408t-6178632ecaee2f8250c0b1e57e93bc125a0ef7789ceab0094fe0c82fcea1044f3</citedby><cites>FETCH-LOGICAL-b408t-6178632ecaee2f8250c0b1e57e93bc125a0ef7789ceab0094fe0c82fcea1044f3</cites><orcidid>0000-0001-7030-9853 ; 0000-0002-6850-4454 ; 0000-0002-7633-271X ; 0000-0001-7388-2436</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27902,27903</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31028155$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ng, Siew C</creatorcontrib><creatorcontrib>Kyaw, Moe Htet</creatorcontrib><creatorcontrib>Suen, Bing Yee</creatorcontrib><creatorcontrib>Tse, Yee Kit</creatorcontrib><creatorcontrib>Wong, Martin C S</creatorcontrib><creatorcontrib>Hui, Aric J</creatorcontrib><creatorcontrib>Tak, Hui Yee</creatorcontrib><creatorcontrib>Lau, James Y W</creatorcontrib><creatorcontrib>Sung, Joseph J Y</creatorcontrib><creatorcontrib>Chan, Francis K L</creatorcontrib><title>Prospective colonoscopic study to investigate risk of colorectal neoplasms in first-degree relatives of patients with non-advanced adenomas</title><title>Gut</title><addtitle>Gut</addtitle><addtitle>Gut</addtitle><description>ObjectiveThe risk associated with a family history of non-advanced adenoma (non-AA) is unknown. We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas.DesignIn a blinded, cross-sectional study, consecutive subjects with newly diagnosed non-AA were identified from our colonoscopy database. 414 FDRs of subjects with non-AA (known as exposed FDRs; mean age 55.0±8.1 years) and 414 age and sex-matched FDRs of subjects with normal findings from colonoscopy (known as unexposed FDRs; mean age 55.2±7.8 years) underwent a colonoscopy from November 2015 to June 2018. One FDR per family was recruited. FDRs with a family history of colorectal cancer were excluded. The primary outcome was prevalence of advanced adenoma (AA). Secondary outcomes included prevalence of all adenomas and cancer.ResultsThe prevalence of AA was 3.9% in exposed FDRs and 2.4% in unexposed FDRs (matched OR (mOR)=1.67; 95% CI 0.72 to 3.91; p=0.238 adjusted for proband sex and proband age). Exposed FDRs had a higher prevalence of any adenomas (29.2% vs 18.6%; mOR=1.87; 95% CI 1.32 to 2.66; p&lt;0.001) and non-AA (25.4% vs 16.2%; mOR=1.91; 95% CI 1.32 to 2.76; p=0.001). A higher proportion of exposed FDRs than unexposed FDRs (4.3% vs 2.2%; adjusted mOR=2.44; 95% CI 1.01 to 5.86; p=0.047) had multiple adenomas. No cancer was detected in both groups.ConclusionA positive family history of non-AA does not significantly increase the risk of clinically important colorectal neoplasia. The data support current guidelines which do not advocate earlier screening in individuals with a family history of non-AA.Trial registration number NCT0252172.</description><subject>Adenoma</subject><subject>Adenoma - epidemiology</subject><subject>Adenoma - genetics</subject><subject>Adult</subject><subject>China - epidemiology</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>colorectal adenomas</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - diagnosis</subject><subject>Colorectal Neoplasms - epidemiology</subject><subject>Colorectal Neoplasms - genetics</subject><subject>Consent</subject><subject>Cross-Sectional Studies</subject><subject>Early Detection of Cancer</subject><subject>Endoscopy</subject><subject>family cancer</subject><subject>Family medical history</subject><subject>Female</subject><subject>Genetic Predisposition to Disease</subject><subject>Health risk assessment</subject><subject>Histology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Tumors</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkc2KFTEQhYMozp3RF3AhATduMqbSf-mlDOoIA7rQdUinK9dcu5M2SV-ZZ_ClzbXHEVyIq6qC7xyq6hDyDPglQNW-2q_54CcmOEhWgQToHpAd1G2ZhJQPyY5z6FjT1f0ZOU_pwDmXsofH5KwCLiQ0zY78-BhDWtBkd0RqwhR8SCYsztCU1_GW5kCdP2LKbq8z0ujSVxrsLzIWlZ6ox7BMOs2pgNS6mDIbcR-xwDjpk286KZbSos-Jfnf5C_XBMz0etTc4Uj2iD7NOT8gjq6eET-_qBfn89s2nq2t28-Hd-6vXN2youcyshU62lUCjEYWVouGGD4BNh301GBCN5mi7TvYG9cB5X1vkRgpbRuB1basL8nLzXWL4tpbb1OySwWnS5ZY1KSGgFbJtJRT0xV_oIazRl-2UqGopuCwvLpTYKFOemSJatUQ363irgKtTVGqLSp2iUltURfT8znodZhzvJb-zKQDbgGE-_J_h5R_-fs1_CH4CGzaxPg</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Ng, Siew C</creator><creator>Kyaw, Moe Htet</creator><creator>Suen, Bing Yee</creator><creator>Tse, Yee Kit</creator><creator>Wong, Martin C S</creator><creator>Hui, Aric J</creator><creator>Tak, Hui Yee</creator><creator>Lau, James Y W</creator><creator>Sung, Joseph J Y</creator><creator>Chan, Francis K L</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ Publishing Group LTD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7030-9853</orcidid><orcidid>https://orcid.org/0000-0002-6850-4454</orcidid><orcidid>https://orcid.org/0000-0002-7633-271X</orcidid><orcidid>https://orcid.org/0000-0001-7388-2436</orcidid></search><sort><creationdate>20200201</creationdate><title>Prospective colonoscopic study to investigate risk of colorectal neoplasms in first-degree relatives of patients with non-advanced adenomas</title><author>Ng, Siew C ; Kyaw, Moe Htet ; Suen, Bing Yee ; Tse, Yee Kit ; Wong, Martin C S ; Hui, Aric J ; Tak, Hui Yee ; Lau, James Y W ; Sung, Joseph J Y ; Chan, Francis K L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b408t-6178632ecaee2f8250c0b1e57e93bc125a0ef7789ceab0094fe0c82fcea1044f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adenoma</topic><topic>Adenoma - epidemiology</topic><topic>Adenoma - genetics</topic><topic>Adult</topic><topic>China - epidemiology</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>colorectal adenomas</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - diagnosis</topic><topic>Colorectal Neoplasms - epidemiology</topic><topic>Colorectal Neoplasms - genetics</topic><topic>Consent</topic><topic>Cross-Sectional Studies</topic><topic>Early Detection of Cancer</topic><topic>Endoscopy</topic><topic>family cancer</topic><topic>Family medical history</topic><topic>Female</topic><topic>Genetic Predisposition to Disease</topic><topic>Health risk assessment</topic><topic>Histology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Studies</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ng, Siew C</creatorcontrib><creatorcontrib>Kyaw, Moe Htet</creatorcontrib><creatorcontrib>Suen, Bing Yee</creatorcontrib><creatorcontrib>Tse, Yee Kit</creatorcontrib><creatorcontrib>Wong, Martin C S</creatorcontrib><creatorcontrib>Hui, Aric J</creatorcontrib><creatorcontrib>Tak, Hui Yee</creatorcontrib><creatorcontrib>Lau, James Y W</creatorcontrib><creatorcontrib>Sung, Joseph J Y</creatorcontrib><creatorcontrib>Chan, Francis K L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ng, Siew C</au><au>Kyaw, Moe Htet</au><au>Suen, Bing Yee</au><au>Tse, Yee Kit</au><au>Wong, Martin C S</au><au>Hui, Aric J</au><au>Tak, Hui Yee</au><au>Lau, James Y W</au><au>Sung, Joseph J Y</au><au>Chan, Francis K L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective colonoscopic study to investigate risk of colorectal neoplasms in first-degree relatives of patients with non-advanced adenomas</atitle><jtitle>Gut</jtitle><stitle>Gut</stitle><addtitle>Gut</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>69</volume><issue>2</issue><spage>304</spage><epage>310</epage><pages>304-310</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>ObjectiveThe risk associated with a family history of non-advanced adenoma (non-AA) is unknown. We determined the prevalence of colorectal neoplasms in subjects who have a first-degree relative (FDR) with non-AA compared with subjects who do not have an FDR with adenomas.DesignIn a blinded, cross-sectional study, consecutive subjects with newly diagnosed non-AA were identified from our colonoscopy database. 414 FDRs of subjects with non-AA (known as exposed FDRs; mean age 55.0±8.1 years) and 414 age and sex-matched FDRs of subjects with normal findings from colonoscopy (known as unexposed FDRs; mean age 55.2±7.8 years) underwent a colonoscopy from November 2015 to June 2018. One FDR per family was recruited. FDRs with a family history of colorectal cancer were excluded. The primary outcome was prevalence of advanced adenoma (AA). Secondary outcomes included prevalence of all adenomas and cancer.ResultsThe prevalence of AA was 3.9% in exposed FDRs and 2.4% in unexposed FDRs (matched OR (mOR)=1.67; 95% CI 0.72 to 3.91; p=0.238 adjusted for proband sex and proband age). Exposed FDRs had a higher prevalence of any adenomas (29.2% vs 18.6%; mOR=1.87; 95% CI 1.32 to 2.66; p&lt;0.001) and non-AA (25.4% vs 16.2%; mOR=1.91; 95% CI 1.32 to 2.76; p=0.001). A higher proportion of exposed FDRs than unexposed FDRs (4.3% vs 2.2%; adjusted mOR=2.44; 95% CI 1.01 to 5.86; p=0.047) had multiple adenomas. No cancer was detected in both groups.ConclusionA positive family history of non-AA does not significantly increase the risk of clinically important colorectal neoplasia. The data support current guidelines which do not advocate earlier screening in individuals with a family history of non-AA.Trial registration number NCT0252172.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>31028155</pmid><doi>10.1136/gutjnl-2018-318117</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7030-9853</orcidid><orcidid>https://orcid.org/0000-0002-6850-4454</orcidid><orcidid>https://orcid.org/0000-0002-7633-271X</orcidid><orcidid>https://orcid.org/0000-0001-7388-2436</orcidid></addata></record>
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subjects Adenoma
Adenoma - epidemiology
Adenoma - genetics
Adult
China - epidemiology
Colon
Colonoscopy
colorectal adenomas
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - epidemiology
Colorectal Neoplasms - genetics
Consent
Cross-Sectional Studies
Early Detection of Cancer
Endoscopy
family cancer
Family medical history
Female
Genetic Predisposition to Disease
Health risk assessment
Histology
Humans
Male
Middle Aged
Patients
Prevalence
Prospective Studies
Risk Assessment - methods
Risk Factors
Studies
Tumors
title Prospective colonoscopic study to investigate risk of colorectal neoplasms in first-degree relatives of patients with non-advanced adenomas
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