Colonoscopic surveillance of first-degree relatives of colorectal cancer patients in a faecal occult blood screening programme

Priscilla Sassoli de Bianchi, Cinzia Campari, Silvia Mancini, Orietta Giuliani, Patrizia Landi, Luisa Paterlini, Carlo Naldoni, Alba C. Finarelli, Fabio Falcini, Maurizio Ponz de Leon, Romano Sassatelli, Elisabetta Borciani, Fabio Fornari, Giorgio Gatti, Marella Zatelli, Corrado Zurlini, Federica Rossi, Rossella Corradini, Rossella Olivetti, Marilena ManfrediPaola Baldazzi, Roberto Nannini, Stefano Zanarini, Vincenzo G. Matarese, Caterina Palmonari, Omero Triossi, Sonia Gordini, Rosa Vattiato, Americo Colamartini, Mauro Palazzi, Mirna Severi, Laura Briganti, Mauro Giovanardi, Coralba Casale, Lauro Bucchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In some Italian areas, colonoscopic surveillance of first-degree relatives (FDRs) of colorectal cancer (CRC) patients is provided as a part of local population-based faecal occult blood test (FOBT) screening programmes. The objective of the present study was to assess the feasibility and early results of this surveillance model. Methods: Data from district screening centres were used to evaluate the process of identification and selection of eligible FDRs (residence in the Emilia-Romagna Region, age 40-75 years, no recent colonoscopy) of screen-detected CRC patients and the detected prevalence of disease. The probability for an FDR to undergo colonoscopy and to be diagnosed with CRC and advanced adenoma was estimated using the Kaplan-Meier method. The sex- and age-standardised ratio of detected prevalence to that expected based on results from a colonoscopy screening study of the Italian general population was estimated. Results: Between 2005 and 2011, 9319 FDRs of 2437 screen-detected CRC patients (3.8 per patient) were identified and contacted. Their likelihood of being eligible for, and accepting, colonoscopy was 0.11 (95% confidence interval: 0.11-0.12). Among the 926 subjects undergoing colonoscopy, the prevalence of previous negative screening FOBT was 63%. Eleven CRCs (1.2%) and 100 advanced adenomas (10.8%) were detected. The standardised ratio of detected prevalence to that expected was 0.91 (95% confidence interval: 0.19-2.66) for CRC and 1.48 (1.04-2.05) for advanced adenoma. Conclusions: The procedure of selection of FDRs was extremely ineffective. Due to previous negative screening tests, the prevalence of disease was less than expected. A population-based FOBT screening programme is a highly unsuitable setting for the provision of surveillance to FDRs of CRC patients.

Original languageEnglish
Pages (from-to)469-473
Number of pages5
JournalCancer Epidemiology
Volume37
Issue number4
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Colonoscopy
  • Colorectal neoplasm
  • Faecal occult blood test
  • Family history
  • Mass screening

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology

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