Although colorectal cancer (CRC) screening guidelines acknowledge the need for earlier screening for high-risk individuals, such as those with family history of CRC, there is limited information on how many years earlier these high-risk individuals should be screened; current practice is based on weak evidence. We aimed to provide risk-adapted recommendations on starting age of CRC screening for individuals with different family histories.
We collected data from nationwide family-cancer datasets in Sweden and calculated risk-adapted starting ages of screening for individuals with different family histories of CRC. Family history was defined as a dynamic (time-dependent) variable allowing for changes during the follow-up period of 1958 through 2015.
During a follow up of 12,829,251 individuals with genealogy information, 173,796 developed CRC. The 10-year cumulative risk for the average-risk population at age 50 y (guideline-recommended age for screening) was 0.44%. Individuals with different family histories of CRC attained this equivalent 0.44% risk 3-32 y earlier than their peers in the general population without such a family history. For example, individuals with 1 affected first-degree relative diagnosed before age 45 reached the corresponding risk level 16 y earlier.
We determined risk-adapted starting ages of CRC screening for close or distant relatives of patients with CRC, using high-quality nationwide datasets. These findings might be used in counselling individuals about the appropriate age to start CRC screening, to optimize screening practice, and to supplement guidelines for CRC screening.
Copyright © 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.
Calculating Starting Age for Screening in Relatives of Patients With Colorectal Cancer Based on Data From Large Nationwide Datasets.
