Screening of relatives with colorectal cancer

Colonoscopy may be better than fiberosigmoidoscopy in screening first-degree relatives of patients with colorectal cancer, but there are no studies documenting decreased overall mortality in screened relatives.

A systematic review including 20 studies with a total of 6 865 subjects was abstracted in DARE. Six of the reports included a control group. The percentage of relatives found to have neoplasms (adenomas or carcinomas) ranged from 1.4% to 63%; for adenomas from 1.4% to 59%, and for carcinomas from 0% to 7.5%. Using faecal occult blood test (3 206 participants) the percentage of neoplasms was 1.7%, the percentage of adenoma was 1.0%; and the percentage of carcinoma was 0.7%. Using fiberosigmoidoscopy (1 199 participants) the percentage of neoplasms was 12.3% (adenomas 10.4%, carcinomas 0.08%). Using colonoscopy (2 562 participants) the percentage of neoplasms was 25.4% (adenoma 21.3%, carcinoma 3.5%).

Comment: The quality of evidence is downgraded by review quality (limited literature search and the quality of the included studies was not assessed).

Ədəbiyyat

1. Brewer DA, Fung CL, Chapuis PH, Bokey EL. Should relatives of patients with colorectal cancer be screened? A critical review of the literature. Dis Colon Rectum 1994 Dec;37(12):1328-38.