Risk of Colorectal Neoplasia in Individuals With Self-Reported Family History: A Prospective Colonoscopy Study from 16 Asia-Pacific Regions

Wong MC 1 , Ching JY 1 , Chiu HM 2 , Wu KC 3 , Rerknimitr R 4 , Li J 5 Show all authors , Wu DC 6 , Goh KL 7 , Matsuda T 8 , Kim HS 9 , Leong R 10 , Yeoh KG 11 , Chong VH 12 , Sollano JD 13 , Ahmed F 14 , Menon J 15 , Ng SC 1 , Wu JC 1 , Chan FK 1 , Sung JJ 1

Affiliations 

  • 1 CUHK JC Bowel Cancer Education Centre, Institute of Digestive Disease, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
  • 2 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 3 Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
  • 4 Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 5 Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
  • 6 Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
  • 7 Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia
  • 8 Division of Endoscopy, National Cancer Center Hospital, Tokyo, Japan
  • 9 Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
  • 10 Bankstown and Concord Hospitals, Sydney, New South Wales, Australia
  • 11 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • 12 Division of Gastroenterology, RIPAS Hospital, Brunei, Darussalam
  • 13 Section of Gastroenterology, University of Santo Tomas Hospital, Manila, Philippines
  • 14 Division of Gastroenterology, Aga Khan University, Karachi, Pakistan
  • 15 Department of Medicine, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
Am J Gastroenterol, 2016 11;111(11):1621-1629.
PMID: 26977757 DOI: 10.1038/ajg.2016.52

Abstract

OBJECTIVES: We tested the hypothesis that the risk of colorectal cancer (CRC), advanced colorectal neoplasia (ACN), and colorectal adenoma among screening participants with different first-degree relatives (FDRs) affected by CRC was similar.

METHODS: A multi-center, prospective colonoscopy study involving 16 Asia-Pacific regions was performed from 2008 to 2015. Consecutive self-referred CRC screening participants aged 40-70 years were recruited, and each subject received one direct optical colonoscopy. The prevalence of CRC, ACN, and colorectal adenoma was compared among subjects with different FDRs affected using Pearson's χ2 tests. Binary logistic regression analyses were performed to evaluate the risk of these lesions, controlling for recognized risk factors including age, gender, smoking habits, alcohol drinking, body mass index, and the presence of diabetes mellitus.

RESULTS: Among 11,797 asymptomatic subjects, the prevalence of CRC was 0.6% (none: 0.6%; siblings: 1.1%; mother: 0.5%; father: 1.2%; ≥2 members: 3.1%, P<0.001), that of ACN was 6.5% (none: 6.1%; siblings: 8.3%; mother: 7.7%; father: 8.7%; ≥2 members: 9.3%, P<0.001), and that of colorectal adenoma was 29.3% (none: 28.6%; siblings: 33.5%; mother: 31.8%; father: 31.1%; ≥2 members: 38.1%, P<0.001). In multivariate regression analyses, subjects with at least one FDR affected were significantly more likely to have CRC (adjusted odds ratio (AOR)=2.02-7.89), ACN (AOR=1.55-2.06), and colorectal adenoma (AOR=1.31-1.92) than those without a family history. The risk of CRC (AOR=0.90, 95% confidence interval (CI) 0.34-2.35, P=0.830), ACN (AOR=1.07, 95% CI 0.75-1.52, P=0.714), and colorectal adenoma (AOR=0.96, 95% CI 0.78-1.19, P=0.718) in subjects with either parent affected was similar to that of subjects with their siblings affected.

CONCLUSIONS: The risk of colorectal neoplasia was similar among subjects with different FDRs affected. These findings do not support the need to discriminate proband identity in screening participants with affected FDRs when their risks of colorectal neoplasia were estimated.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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