Table 1.

Key Concepts

Colorectal cancer occurs with increased incidence in family members of persons with this malignancy, even outside the known inherited syndromes. Studies have shown that adenomatous polyps, the precursors of most colorectal cancers, also occur with increased incidence in relatives of persons with colorectal cancer, and visa versa. Health policy organizations have included family history as a risk factor to consider in colorectal cancer screening and have given specific screening recommendations related to the strength of the family history. The present study did not find an increased occurrence of advanced neoplasia (polyps ≥ 10mm, villous or advanced dysplasia component, or adenocarcinoma) in persons with a family history of CRC compared to those without. Ascertainment of subjects, however, excluded many patients with colonic neoplasia that may likely have affected the negative result. Future studies should incorporate the best methodologies and analytical tools available to further refine familial risk estimates and screening guidelines before any changes are made in familial risk estimates of adenomatous polyp occurrence and CRC screening guidelines.