Relatives Of People with Colorectal Polyps Face Increased Risk For Colorectal Cancer

NEW YORK, NY. June 1, 1998 -- Researchers at the Columbia University College of Physicians & Surgeons have discovered that close relatives of individuals who have colon polyps (non-cancerous growths, or adenomas) face as high a risk of developing colorectal cancer as do people who have relatives with colorectal cancer itself. The research is reported in the June 1 issue of Annals of Internal Medicine.

"Our study may alter the screening approach to colorectal cancer, because it suggests that this population should get colonoscopy rather than sigmoidoscopy, which is more aggressive than previous recommendations," says Alfred I. Neugut, M.D., Ph.D., associate clinical professor of public health and medicine and co-author of the paper with Habibul Ahsan, MBBS; Gail Garbowski, MPH; Judith Jacobson, DrPH; Kenneth Forde, M.D.; Michael Treat, M.D.; and Jerome Waye, M.D.

Three tests are used to detect colorectal cancer and the polyps that often precede them -- a fecal occult blood test, sigmoidoscopy, and colonoscopy. Typically, sigmoidoscopy is used with fecal occult blood testing for screening the general population, with the more invasive colonoscopy reserved for people with a family history of colorectal cancer, who undergo it every three to five years. According to current guidelines, relatives of people with adenomas should have a yearly fecal occult blood test, with follow-up colonoscopy if results are positive. A family history of polyps or colon cancer can reflect genes that predispose to colorectal cancer, or shared dietary or other lifestyle habits that could contribute to developing the disorder.

"Over the last 20 to 30 years we have learned that by screening for colorectal cancer, both with fecal occult blood tests and sigmoidoscopy -- a flexible tube up the rectum -- we can lower mortality by 70 to 80 percent. Sigmoidoscopy screens only the distal half of the colon, so colonoscopy, which checks the entire colon, might dec

Contact: Carolyn Conway
Columbia University Medical Center

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