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Calculating the Starting Age for Screening in Relatives of Patients With Colorectal Cancer Based on Data From Large Nationwide Data Sets

Tian, Yu LU ; Kharazmi, Elham LU ; Brenner, Hermann LU ; Xu, Xing LU ; Sundquist, Kristina LU ; Sundquist, Jan LU and Fallah, Mahdi LU (2020) In Gastroenterology 159(1). p.3-168
Abstract

BACKGROUND & AIMS: 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 the starting age of CRC screening for individuals with different family histories.

METHODS: We collected data from nationwide family-cancer data sets 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... (More)

BACKGROUND & AIMS: 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 the starting age of CRC screening for individuals with different family histories.

METHODS: We collected data from nationwide family-cancer data sets 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.

RESULTS: 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 years (the guideline-recommended age for screening) was 0.44%. Individuals with different family histories of CRC attained this equivalent 0.44% risk 3-29 years 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 years reached the corresponding risk level 16 years earlier.

CONCLUSIONS: We determined risk-adapted starting ages of CRC screening for close or distant relatives of patients with CRC, using high quality nationwide data sets. 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.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gastroenterology
volume
159
issue
1
pages
3 - 168
publisher
Elsevier
external identifiers
  • scopus:85088258746
  • pmid:32251666
ISSN
1528-0012
DOI
10.1053/j.gastro.2020.03.063
language
English
LU publication?
yes
additional info
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
id
a9db1838-5293-488b-8e41-176df1cf9ec7
date added to LUP
2020-09-27 14:05:32
date last changed
2024-06-12 20:46:18
@article{a9db1838-5293-488b-8e41-176df1cf9ec7,
  abstract     = {{<p>BACKGROUND &amp; AIMS: 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 the starting age of CRC screening for individuals with different family histories.</p><p>METHODS: We collected data from nationwide family-cancer data sets 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.</p><p>RESULTS: 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 years (the guideline-recommended age for screening) was 0.44%. Individuals with different family histories of CRC attained this equivalent 0.44% risk 3-29 years 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 years reached the corresponding risk level 16 years earlier.</p><p>CONCLUSIONS: We determined risk-adapted starting ages of CRC screening for close or distant relatives of patients with CRC, using high quality nationwide data sets. 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.</p>}},
  author       = {{Tian, Yu and Kharazmi, Elham and Brenner, Hermann and Xu, Xing and Sundquist, Kristina and Sundquist, Jan and Fallah, Mahdi}},
  issn         = {{1528-0012}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{3--168}},
  publisher    = {{Elsevier}},
  series       = {{Gastroenterology}},
  title        = {{Calculating the Starting Age for Screening in Relatives of Patients With Colorectal Cancer Based on Data From Large Nationwide Data Sets}},
  url          = {{http://dx.doi.org/10.1053/j.gastro.2020.03.063}},
  doi          = {{10.1053/j.gastro.2020.03.063}},
  volume       = {{159}},
  year         = {{2020}},
}