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The impact of new screening protocol on individuals at increased risk of colorectal cancer.
Colorectal Dis 2007; 9(7):635-40CD

Abstract

OBJECTIVE

Screening colonoscopy has been shown to reduce mortality and cancer stage in hereditary nonpolyposis colorectal cancer (HNPCC) individuals. However, the benefit of screening in intermediate risk groups is unknown. The most recent national guidelines have recommended a reduction of screening frequency for the intermediate risk group. Therefore, this study aims to compare the results of colonoscopic screening in HNPCC and intermediate risk groups and assess the effect of the most recent screening protocol recommendations.

METHOD

A total of 244 individuals; 108 from HNPCC families (28 mismatch repair gene carriers) and 136 from intermediate risk families were referred for regular colonoscopic screening by the Regional Genetics Service. Findings from 417 colonoscopies performed between 1992 and 2003 were evaluated.

RESULTS

A total of three cancers, 39 adenomas and 41 hyperplastic polyps were found in the HNPCC group compared with one cancer, 22 adenomas and 19 hyperplasic polyps in the intermediate risk group. If the recent screening guidelines for the intermediate group were applied, then 89 (44%) fewer colonoscopies would have been performed. Although no cancers would have been missed, six adenomas (mean size = 5.7 mm, range 2-10 mm) with two graded as severely dysplasic and six hyperplastic polyps would not have been detected.

CONCLUSION

The detection rate and distribution of adenomas were similar in both groups. If the new colonoscopic screening recommendations for the intermediate risk group had been applied, a small number of significant lesions would have been missed.

Authors+Show Affiliations

Department of General Surgery, Manchester Royal Infirmary, and Academic Unit of Medical Genetics and Regional Genetics Service, St. Mary's Hospital, Manchester, UK. tonymak2000@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17824981

Citation

Mak, T, et al. "The Impact of New Screening Protocol On Individuals at Increased Risk of Colorectal Cancer." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 9, no. 7, 2007, pp. 635-40.
Mak T, Senevrayar K, Lalloo F, et al. The impact of new screening protocol on individuals at increased risk of colorectal cancer. Colorectal Dis. 2007;9(7):635-40.
Mak, T., Senevrayar, K., Lalloo, F., Evans, D. G., & Hill, J. (2007). The impact of new screening protocol on individuals at increased risk of colorectal cancer. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 9(7), pp. 635-40.
Mak T, et al. The Impact of New Screening Protocol On Individuals at Increased Risk of Colorectal Cancer. Colorectal Dis. 2007;9(7):635-40. PubMed PMID: 17824981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of new screening protocol on individuals at increased risk of colorectal cancer. AU - Mak,T, AU - Senevrayar,K, AU - Lalloo,F, AU - Evans,D G R, AU - Hill,J, PY - 2007/9/11/pubmed PY - 2007/12/6/medline PY - 2007/9/11/entrez SP - 635 EP - 40 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 9 IS - 7 N2 - OBJECTIVE: Screening colonoscopy has been shown to reduce mortality and cancer stage in hereditary nonpolyposis colorectal cancer (HNPCC) individuals. However, the benefit of screening in intermediate risk groups is unknown. The most recent national guidelines have recommended a reduction of screening frequency for the intermediate risk group. Therefore, this study aims to compare the results of colonoscopic screening in HNPCC and intermediate risk groups and assess the effect of the most recent screening protocol recommendations. METHOD: A total of 244 individuals; 108 from HNPCC families (28 mismatch repair gene carriers) and 136 from intermediate risk families were referred for regular colonoscopic screening by the Regional Genetics Service. Findings from 417 colonoscopies performed between 1992 and 2003 were evaluated. RESULTS: A total of three cancers, 39 adenomas and 41 hyperplastic polyps were found in the HNPCC group compared with one cancer, 22 adenomas and 19 hyperplasic polyps in the intermediate risk group. If the recent screening guidelines for the intermediate group were applied, then 89 (44%) fewer colonoscopies would have been performed. Although no cancers would have been missed, six adenomas (mean size = 5.7 mm, range 2-10 mm) with two graded as severely dysplasic and six hyperplastic polyps would not have been detected. CONCLUSION: The detection rate and distribution of adenomas were similar in both groups. If the new colonoscopic screening recommendations for the intermediate risk group had been applied, a small number of significant lesions would have been missed. SN - 1462-8910 UR - https://www.unboundmedicine.com/medline/citation/17824981/The_impact_of_new_screening_protocol_on_individuals_at_increased_risk_of_colorectal_cancer_ L2 - https://doi.org/10.1111/j.1463-1318.2006.01203.x DB - PRIME DP - Unbound Medicine ER -