Abstract
BACKGROUND: People with a family history of colorectal cancer have an increased risk of the disease themselves. Many centres are advocating family history screening by endoscopy. AIMS: The performance of chemical and immunological faecal occult blood tests (Haemoccult and Hemeselect) in 212 subjects with a family history of colorectal cancer was assessed. RESULTS: Both Hemeselect and Haemoccult were positive in the only patient with colorectal cancer. Hemeselect was more sensitive than Haemoccult for adenomas (40% compared with 20%) (adenomas larger than 1 cm 75% compared with 50%). No additional abnormality was detected by the addition of Haemoccult or Hemeselect to 60 cm flexible sigmoidoscopy in screening people at lower levels of familial risk. A false positive rate of 16% for Hemeselect resulted in a high proportion of additional colonoscopies in this group. CONCLUSIONS: At present faecal occult blood tests are not sufficiently sensitive or specific to replace endoscopy in screening people at risk of familial colorectal cancer.
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Selected References
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- Cannon-Albright L. A., Skolnick M. H., Bishop D. T., Lee R. G., Burt R. W. Common inheritance of susceptibility to colonic adenomatous polyps and associated colorectal cancers. N Engl J Med. 1988 Sep 1;319(9):533–537. doi: 10.1056/NEJM198809013190902. [DOI] [PubMed] [Google Scholar]
- Dunlop M. G. Screening for large bowel neoplasms in individuals with a family history of colorectal cancer. Br J Surg. 1992 Jun;79(6):488–494. doi: 10.1002/bjs.1800790606. [DOI] [PubMed] [Google Scholar]
- Guillem J. G., Forde K. A., Treat M. R., Neugut A. I., O'Toole K. M., Diamond B. E. Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of colon cancer patients. A controlled, prospective study. Dis Colon Rectum. 1992 Jun;35(6):523–529. doi: 10.1007/BF02050530. [DOI] [PubMed] [Google Scholar]
- Guillem J. G., Forde K. A., Treat M. R., Neugut A. I., O'Toole K. M., Diamond B. E. Colonoscopic screening for neoplasms in asymptomatic first-degree relatives of colon cancer patients. A controlled, prospective study. Dis Colon Rectum. 1992 Jun;35(6):523–529. doi: 10.1007/BF02050530. [DOI] [PubMed] [Google Scholar]
- Hardcastle J. D., Thomas W. M., Chamberlain J., Pye G., Sheffield J., James P. D., Balfour T. W., Amar S. S., Armitage N. C., Moss S. M. Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Results for first 107,349 subjects. Lancet. 1989 May 27;1(8648):1160–1164. doi: 10.1016/s0140-6736(89)92750-5. [DOI] [PubMed] [Google Scholar]
- Houlston R. S., Murday V., Harocopos C., Williams C. B., Slack J. Screening and genetic counselling for relatives of patients with colorectal cancer in a family cancer clinic. BMJ. 1990 Aug 18;301(6748):366–368. doi: 10.1136/bmj.301.6748.366. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kewenter J., Björk S., Haglind E., Smith L., Svanvik J., Ahrén C. Screening and rescreening for colorectal cancer. A controlled trial of fecal occult blood testing in 27,700 subjects. Cancer. 1988 Aug 1;62(3):645–651. doi: 10.1002/1097-0142(19880801)62:3<645::aid-cncr2820620333>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
- Kronborg O., Fenger C., Olsen J., Bech K., Søndergaard O. Repeated screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen, Denmark. Scand J Gastroenterol. 1989 Jun;24(5):599–606. doi: 10.3109/00365528909093096. [DOI] [PubMed] [Google Scholar]
- Lynch H. T., Smyrk T. C., Watson P., Lanspa S. J., Lynch J. F., Lynch P. M., Cavalieri R. J., Boland C. R. Genetics, natural history, tumor spectrum, and pathology of hereditary nonpolyposis colorectal cancer: an updated review. Gastroenterology. 1993 May;104(5):1535–1549. doi: 10.1016/0016-5085(93)90368-m. [DOI] [PubMed] [Google Scholar]
- Mandel J. S., Bond J. H., Church T. R., Snover D. C., Bradley G. M., Schuman L. M., Ederer F. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993 May 13;328(19):1365–1371. doi: 10.1056/NEJM199305133281901. [DOI] [PubMed] [Google Scholar]
- Mandel J. S., Bond J. H., Church T. R., Snover D. C., Bradley G. M., Schuman L. M., Ederer F. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993 May 13;328(19):1365–1371. doi: 10.1056/NEJM199305133281901. [DOI] [PubMed] [Google Scholar]
- Rozen P., Fireman Z., Figer A., Legum C., Ron E., Lynch H. T. Family history of colorectal cancer as a marker of potential malignancy within a screening program. Cancer. 1987 Jul 15;60(2):248–254. doi: 10.1002/1097-0142(19870715)60:2<248::aid-cncr2820600223>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- St John D. J., McDermott F. T., Hopper J. L., Debney E. A., Johnson W. R., Hughes E. S. Cancer risk in relatives of patients with common colorectal cancer. Ann Intern Med. 1993 May 15;118(10):785–790. doi: 10.7326/0003-4819-118-10-199305150-00005. [DOI] [PubMed] [Google Scholar]
- St John D. J., McDermott F. T., Hopper J. L., Debney E. A., Johnson W. R., Hughes E. S. Cancer risk in relatives of patients with common colorectal cancer. Ann Intern Med. 1993 May 15;118(10):785–790. doi: 10.7326/0003-4819-118-10-199305150-00005. [DOI] [PubMed] [Google Scholar]
- Stephenson B. M., Finan P. J., Gascoyne J., Garbett F., Murday V. A., Bishop D. T. Frequency of familial colorectal cancer. Br J Surg. 1991 Oct;78(10):1162–1166. doi: 10.1002/bjs.1800781005. [DOI] [PubMed] [Google Scholar]
- Stephenson B. M., Murday V. A., Finan P. J., Quirke P., Dixon M. F., Bishop D. T. Feasibility of family based screening for colorectal neoplasia: experience in one general surgical practice. Gut. 1993 Jan;34(1):96–100. doi: 10.1136/gut.34.1.96. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stubbs R. S., Nadkarni D. M., Monsey H. A. Faecal carcinoembryonic antigen in colorectal cancer patients. Gut. 1986 Aug;27(8):901–905. doi: 10.1136/gut.27.8.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thomas W. M., Hardcastle J. D., Jackson J., Pye G. Chemical and immunological testing for faecel occult blood: a comparison of two tests in symptomatic patients. Br J Cancer. 1992 Apr;65(4):618–620. doi: 10.1038/bjc.1992.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
