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Thursday, August 21, 2014
Family History of Colon Cancer
I am a 54 y,o. WM physician in completely good health, no symptoms or findings for any GI disease. My mother, now age 77, had a proximal colon resection for adenoca three years ago with no recurrence on recent colonoscopy. Would like recommendation re: need for screening colonoscopy on myself, with supporting reference(s), Thank you.
Most population-based studies have shown that individuals with one first-degree relative (FDR), i.e. parent, sibling, or child, with colon cancer have a 2 to 3 fold increase in their lifetime risk for developing colon cancer. This is equal to a 10-15% risk by age 80 for the average Caucasian-American male. This risk may be higher if the first-degree relative is less than 50 at the time of diagnosis, or if there is an inherited pattern of cancer in the family.
The appropriate screening for individuals with one FDR with colon cancer is unclear. While most studies agree that these individuals do have a slightly increased risk for colon cancer, they do not agree about the types of screening that should be done or when this screening should begin. The American Cancer Society recommends that any individual 40 or over with 1 or more FDR with colon cancer undergo a yearly digital rectal exam, yearly stool blood test, yearly Barium enema with sigmoidoscopy, or total colonoscopy every 3 to 5 years. This 3 to 5 year interval may be decreased if pre-cancerous polpys or other conditions are found. For individuals with a family history of colon cancer of the proximal or right side, a colonoscopy would be better.
Brewer, et al. Disease of the Colon and Rectum, 1994; vol 37(12):1328-1338.
Fuchs, et al. New England Journal of Medicine, 1994; vol 331(25): 1669-1674
Pariente, et al. Gastroenterology 1998; vol 115: 7-12
Rebecca J Nagy, MS, CGC
Formerly, Clinical Instructor of Genetics
School of Medicine
Case Western Reserve University
Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University