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Colon cancer screening practices following genetic testing for hereditary nonpolyposis colon cancer (HNPCC) mutations.
Arch Intern Med. 2004 Sep 27; 164(17):1881-7.AI

Abstract

BACKGROUND

Although increased colonoscopic surveillance is recommended for hereditary nonpolyposis colon cancer (HNPCC) mutation carriers, limited information is available on adherence to colorectal cancer screening recommendations. This study investigated colonoscopy practices following genetic testing for HNPCC mutations.

METHODS

This prospective cohort study was conducted between May 22, 1996, and November 13, 1999. Participants were 98 men and women without a personal history of colon cancer or colectomy who were identified from 11 extended HNPCC families. Colonoscopy use was evaluated by telephone before genetic counseling and was reassessed 1, 6, and 12 months following test results disclosure.

RESULTS

During the 12 months following genetic counseling and testing, 73% (16/22) of HNPCC mutation carriers, 16% (8/49) of noncarriers, and 22% (6/27) of decliners reported having a colonoscopy (chi(2) = 23.97, P<.001). After controlling for clinical factors and pretest screening practices, HNPCC mutation carriers were significantly more likely than test decliners to have a colonoscopy (odds ratio [OR], 12.12; 95% confidence interval [CI], 3.42-42.96; P<.001). There were no differences in colonoscopy use between noncarriers and decliners (OR, 0.60; 95% CI, 0.28-1.29; P =.19). Perceived control over developing colon cancer also had a significant effect on posttest colonoscopy use (OR, 2.19; 95% CI, 1.22-3.94; P =.01).

CONCLUSIONS

Genetic testing may motivate increased colonoscopic screening among HNPCC mutation carriers. Increased efforts may be needed to assess patients' family histories of colon cancer and provide appropriate referrals for genetic counseling and testing to target colonoscopic screening to high-risk individuals.

Authors+Show Affiliations

Abramson Cancer Center, Department of Psychiatry, and Annenberg Public Policy Center, University of Pennsylvania, 19104, USA. Chanita@mail.med.upenn.eduNo affiliation info availableNo 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

15451763

Citation

Halbert, Chanita Hughes, et al. "Colon Cancer Screening Practices Following Genetic Testing for Hereditary Nonpolyposis Colon Cancer (HNPCC) Mutations." Archives of Internal Medicine, vol. 164, no. 17, 2004, pp. 1881-7.
Halbert CH, Lynch H, Lynch J, et al. Colon cancer screening practices following genetic testing for hereditary nonpolyposis colon cancer (HNPCC) mutations. Arch Intern Med. 2004;164(17):1881-7.
Halbert, C. H., Lynch, H., Lynch, J., Main, D., Kucharski, S., Rustgi, A. K., & Lerman, C. (2004). Colon cancer screening practices following genetic testing for hereditary nonpolyposis colon cancer (HNPCC) mutations. Archives of Internal Medicine, 164(17), 1881-7.
Halbert CH, et al. Colon Cancer Screening Practices Following Genetic Testing for Hereditary Nonpolyposis Colon Cancer (HNPCC) Mutations. Arch Intern Med. 2004 Sep 27;164(17):1881-7. PubMed PMID: 15451763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colon cancer screening practices following genetic testing for hereditary nonpolyposis colon cancer (HNPCC) mutations. AU - Halbert,Chanita Hughes, AU - Lynch,Henry, AU - Lynch,Jane, AU - Main,David, AU - Kucharski,Susan, AU - Rustgi,Anil K, AU - Lerman,Caryn, PY - 2004/9/29/pubmed PY - 2005/2/18/medline PY - 2004/9/29/entrez SP - 1881 EP - 7 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 164 IS - 17 N2 - BACKGROUND: Although increased colonoscopic surveillance is recommended for hereditary nonpolyposis colon cancer (HNPCC) mutation carriers, limited information is available on adherence to colorectal cancer screening recommendations. This study investigated colonoscopy practices following genetic testing for HNPCC mutations. METHODS: This prospective cohort study was conducted between May 22, 1996, and November 13, 1999. Participants were 98 men and women without a personal history of colon cancer or colectomy who were identified from 11 extended HNPCC families. Colonoscopy use was evaluated by telephone before genetic counseling and was reassessed 1, 6, and 12 months following test results disclosure. RESULTS: During the 12 months following genetic counseling and testing, 73% (16/22) of HNPCC mutation carriers, 16% (8/49) of noncarriers, and 22% (6/27) of decliners reported having a colonoscopy (chi(2) = 23.97, P<.001). After controlling for clinical factors and pretest screening practices, HNPCC mutation carriers were significantly more likely than test decliners to have a colonoscopy (odds ratio [OR], 12.12; 95% confidence interval [CI], 3.42-42.96; P<.001). There were no differences in colonoscopy use between noncarriers and decliners (OR, 0.60; 95% CI, 0.28-1.29; P =.19). Perceived control over developing colon cancer also had a significant effect on posttest colonoscopy use (OR, 2.19; 95% CI, 1.22-3.94; P =.01). CONCLUSIONS: Genetic testing may motivate increased colonoscopic screening among HNPCC mutation carriers. Increased efforts may be needed to assess patients' family histories of colon cancer and provide appropriate referrals for genetic counseling and testing to target colonoscopic screening to high-risk individuals. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15451763/Colon_cancer_screening_practices_following_genetic_testing_for_hereditary_nonpolyposis_colon_cancer__HNPCC__mutations_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.17.1881 DB - PRIME DP - Unbound Medicine ER -