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Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer.
J Clin Oncol 2004; 22(1):39-44JC

Abstract

PURPOSE

Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common hereditary form of colon cancer. Cancer screening recommendations differ between individuals identified to carry an HNPCC mutation and those who do not carry a known family mutation. We assessed the impact of genetic counseling and testing (GCT) on the use of endoscopic screening procedures and adherence to recommended endoscopic screening guidelines in 56 asymptomatic at-risk individuals from families known to carry an HNPCC mutation.

PATIENTS AND METHODS

We analyzed data on colonoscopy and flexible sigmoidoscopy screenings collected before GCT and 6 months and 12 months post-GCT on 17 mutation-positive and 39 true mutation-negative individuals. Main outcome measures were use of endoscopic screening and adherence to recommended guidelines for the relevant mutation status. Mutation status, age, sex, employment, and income were analyzed as predictor variables.

RESULTS

Among mutation-negative individuals, use of colonoscopy and flexible sigmoidoscopy decreased significantly between pre- and post-GCT (P <.00001 and P <.0003, respectively). Among mutation-positive individuals, a nonsignificant increase (P =.24) in use was noted. Age was also associated with use of endoscopic screening after GCT (P =.03). Mutation status (odds ratio [OR], 7.5; P =.02) and employment (OR, 8.6; P =.025) were associated with nonadherence to endoscopic screening guidelines. More mutation-negative individuals strictly adhered to guidelines than did mutation-positive individuals (87% v 65%).

CONCLUSION

Genetic counseling and testing for HNPCC significantly influences the use of colonic endoscopy and adherence to recommendations for colon cancer screening.

Authors+Show Affiliations

Genetic Counseling Research Unit, Medical Genetics Branch, National Human Genome Research Institute/NIH, 10 Center Drive, MSC 1852, Bldg 10/Room 10 C103, Bethesda, MD 20892-1852, USA. dhadley@nhgri.nih.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14701766

Citation

Hadley, Donald W., et al. "Colon Cancer Screening Practices After Genetic Counseling and Testing for Hereditary Nonpolyposis Colorectal Cancer." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 22, no. 1, 2004, pp. 39-44.
Hadley DW, Jenkins JF, Dimond E, et al. Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer. J Clin Oncol. 2004;22(1):39-44.
Hadley, D. W., Jenkins, J. F., Dimond, E., de Carvalho, M., Kirsch, I., & Palmer, C. G. (2004). Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 22(1), pp. 39-44.
Hadley DW, et al. Colon Cancer Screening Practices After Genetic Counseling and Testing for Hereditary Nonpolyposis Colorectal Cancer. J Clin Oncol. 2004 Jan 1;22(1):39-44. PubMed PMID: 14701766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer. AU - Hadley,Donald W, AU - Jenkins,Jean F, AU - Dimond,Eileen, AU - de Carvalho,Maria, AU - Kirsch,Ilan, AU - Palmer,Christina G S, PY - 2004/1/1/pubmed PY - 2004/1/28/medline PY - 2004/1/1/entrez SP - 39 EP - 44 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 22 IS - 1 N2 - PURPOSE: Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common hereditary form of colon cancer. Cancer screening recommendations differ between individuals identified to carry an HNPCC mutation and those who do not carry a known family mutation. We assessed the impact of genetic counseling and testing (GCT) on the use of endoscopic screening procedures and adherence to recommended endoscopic screening guidelines in 56 asymptomatic at-risk individuals from families known to carry an HNPCC mutation. PATIENTS AND METHODS: We analyzed data on colonoscopy and flexible sigmoidoscopy screenings collected before GCT and 6 months and 12 months post-GCT on 17 mutation-positive and 39 true mutation-negative individuals. Main outcome measures were use of endoscopic screening and adherence to recommended guidelines for the relevant mutation status. Mutation status, age, sex, employment, and income were analyzed as predictor variables. RESULTS: Among mutation-negative individuals, use of colonoscopy and flexible sigmoidoscopy decreased significantly between pre- and post-GCT (P <.00001 and P <.0003, respectively). Among mutation-positive individuals, a nonsignificant increase (P =.24) in use was noted. Age was also associated with use of endoscopic screening after GCT (P =.03). Mutation status (odds ratio [OR], 7.5; P =.02) and employment (OR, 8.6; P =.025) were associated with nonadherence to endoscopic screening guidelines. More mutation-negative individuals strictly adhered to guidelines than did mutation-positive individuals (87% v 65%). CONCLUSION: Genetic counseling and testing for HNPCC significantly influences the use of colonic endoscopy and adherence to recommendations for colon cancer screening. SN - 0732-183X UR - https://www.unboundmedicine.com/medline/citation/14701766/Colon_cancer_screening_practices_after_genetic_counseling_and_testing_for_hereditary_nonpolyposis_colorectal_cancer_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2004.06.128?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -