Article Figures & Data
Figures
- Figure 1.
Screening pathway for diagnosing patients with a family history of CRC or adenomas
CRC—colorectal cancer, FDR—first-degree relative, FIT—fecal immunochemical testing, SDR—second-degree relative.
Tables
- Table 1.
The GRADE assessment of recommendations for screening for CRC in individuals with a family history of nonhereditary CRC or adenomas
RECOMMENDATION GRADE CONCLUSION 1 FDR with history of CRC • Colonoscopy is the preferred screening test Conditional recommendation, very low-quality evidence • FIT is suggested as a second-line screening option Conditional recommendation, moderate-quality evidence • Screening should commence at age 40–50 y or 10 y younger than the age of diagnosis of FDR Conditional recommendation, very low-quality evidence • Screening interval should be 5–10 y for colonoscopy and 1–2 y for FIT Conditional recommendation, very low-quality evidence ≥ 2 FDRs with CRC • Colonoscopy is the preferred screening test Strong recommendation, very low-quality evidence • Colonoscopy should commence at age 40 y or 10 y younger than earliest age of diagnosis of FDR Conditional recommendation, very low-quality evidence • Colonoscopy screening interval should be 5 y Conditional recommendation, very low-quality evidence ≥ 1 SDRs with CRC • Screening should follow average-risk guidelines starting at age 50 y Conditional recommendation, very low-quality evidence ≥ 1 FDRs with advanced adenomas • Colonoscopy or FIT are suggested for screening Conditional recommendation, very low-quality evidence • Screening should commence at age 40–50 y or 10 y younger than age of diagnosis of FDR Conditional recommendation, very low-quality evidence • Screening interval should be 5–10 y for colonoscopy and 1–2 y for FIT Conditional recommendation, very low-quality evidence ≥ 1 FDR with non-advanced adenomas or polyp of unknown histology • Screening should follow average-risk guidelines Conditional recommendation, very low-quality evidence CRC—colorectal cancer; FDR—first-degree relative; FIT—fecal immunochemical testing; GRADE—Grading of Recommendations Assessment, Development and Evaluation; SDR—second-degree relative.
RISK FACTOR RR BMI > 34 kg/m2 1.49 Physical inactivity 1.44 Smoking, 5 pack-years 1.06 Non-Mediterranean diet 1.91 BMI—body mass index, CRC—colorectal cancer, RR—relative risk.
Data from Johnson et al26 and Doubeni and Fletcher.27
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Colorectal cancer screening for patients with a family history of colorectal cancer or adenomas
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