Familial component of early-onset colorectal cancer: opportunity for prevention
Author:
Daca-Alvarez Maria1ORCID, Martí Marc2, Spinelli Antonino3ORCID, de Miranda Noel F F C4, Palles Claire5, Vivas Alfredo6, Lachtford Andrew7, Monahan Kevin78, Szczepkowski Marek9, Tarnowski Wieslaw10, Makkai-Popa Silviu-Tiberiu11, Vidal Rosario12, López Irene13, Hurtado Elena14, Jiménez Fernando15, Jiménez-Toscano Marta16, Álvaro Edurne17, Sanz Gonzalo18, Ballestero Araceli19, Melone Sirio20, Brandáriz Lorena21, Prieto Isabel22, García-Olmo Damián23ORCID, Ocaña Teresa1, Moreira Rebeca1, Moreno Lorena1, Carballal Sabela1, Moreira Leticia1, Pellisé Maria1, González-Sarmiento Rogelio24, Holowatyj Andreana N25, Perea José24ORCID, Balaguer Francesc1, Santos A C, Martínez M, Moreno V, Ruffinelli Jose Carlos J C, Inglada-Pérez L, Rueda J, Castellano V, Hernández-Villafranca S, Escanciano M, Cavero A, Portugal V, Domenech M, Jiménez L, Peligros I, Rey C, Zorrilla J, Cuatrecasas M, Sánchez A, Rivero-Sanchez L, Iglesias M, de Molina A Ramírez, Colmenarejo G, Espinosa-Salinas I, Fernández L, de Cedrón M Gómez, Corchete L, García J L, García P, Hernández A, Martel A, Pérez J, Burdaspal A, de Fuenmayor M, Forero A, Rubio I, Fernández J, Pastor E, Villafañe A, Alonso O, Encinas S, Teijo A, Pastor C, Arredondo J, Baixauli J, Ceniceros L, Rodriguez J, Sánchez C, Die J, Fernández J, Ocaña J, Dziakova J, Picazo S, Sanz R, Suárez M, Alcazar J, García J, Urioste M, Malats N, Estudillo L, Pérez-Pérez J, Espín E, Marinello F, Kraft M, Landolfi S, Pares B, Verdaguer M, Valverde I, Narváez C, Borycka K, Gellert R, Kołacin D, Ziółkowski B, Curley H, Tomlinson I, Foppa C, Maroli A, Abdulrahman M, Nielsen M, Azagra J, Pascotto B, Ali M, Anele C, Faiz O, Uryszek M, Aseem R, Pawa N,
Affiliation:
1. Department of Gastroenterology, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona , Barcelona , Spain 2. Department of Surgery, Vall d’Hebron University Hospital , Barcelona , Spain 3. Division of Colon and Rectal Surgery, Humanitas Research Hospital, Humanitas University , Rozzano , Italy 4. Department of Pathology, Leiden University Medical Centre , Leiden , the Netherlands 5. Gastrointestinal Cancer Genetics Laboratory, Institute of Cancer and Genomic Sciences, University of Birmingham , Birmingham , UK 6. Department of Surgery, Hospital Universitario 12 de Octubre , Madrid , Spain 7. Polyposis Registry and Family Cancer Clinic, St Mark’s Hospital , London , UK 8. Department of Gastroenterology, West Middlesex University Hospital , London , UK 9. Clinical Department of Colorectal, General and Oncological Surgery, Centre of Postgraduate Medical Education, Bielanski Hospital , Warsaw , Poland 10. Department of Surgery, Centre of Postgraduate Medical Education, Orlowski Hospital , Warsaw , Poland 11. Department of Surgery, Centre Hospitalier de Luxembourg , Luxembourg , Belgium 12. Medical Oncology Department, Hospital Universitario de Salamanca , Salamanca , Spain 13. Department of Surgery, Hospital MD Anderson , Madrid , Spain 14. Department of Surgery, Hospital Universitario Gregorio Marañon , Madrid , Spain 15. Department of Surgery, Hospital Galdakao-Usansolo , Vizcaya , Spain 16. Department of Surgery, Hospital del Mar , Barcelona , Spain 17. Department of Surgery, Hospital Universitario Infanta Leonor , Madrid , Spain 18. Department of Surgery, Hospital Clínico San Carlos , Madrid , Spain 19. Department of Surgery, Hospital Universitario Ramon y Cajal , Madrid , Spain 20. Department of Surgery, Hospital Universitario Fundación Alcorcón , Madrid , Spain 21. Department of Surgery, Hospital Universitario General de Villalba , Madrid , Spain 22. Department of Surgery, Hospital Universitario La Paz , Madrid , Spain 23. Department of Surgery, Hospital Universitario Fundación Jiménez Díaz , Madrid , Spain 24. Molecular Medicine Unit, Department of Medicine, Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University of Salamanca-SACYL-CSIC , Salamanca , Spain 25. Department of Medicine, Vanderbilt University Medical Center , Nashville, Tennessee , USA
Abstract
Abstract
Background
Individuals with a non-syndromic family history of colorectal cancer are known to have an increased risk. There is an opportunity to prevent early-onset colorectal cancer (age less than 50 years) (EOCRC) in this population. The aim was to explore the proportion of EOCRC that is preventable due to family history of colorectal cancer.
Methods
This was a retrospective multicentre European study of patients with non-hereditary EOCRC. The impact of the European Society of Gastrointestinal Endoscopy (ESGE), U.S. Multi-Society Task Force (USMSTF), and National Comprehensive Cancer Network (NCCN) guidelines on prevention and early diagnosis was compared. Colorectal cancer was defined as potentially preventable if surveillance colonoscopy would have been performed at least 5 years before the age of diagnosis of colorectal cancer, and diagnosed early if colonoscopy was undertaken between 1 and 4 years before the diagnosis.
Results
Some 903 patients with EOCRC were included. Criteria for familial colorectal cancer risk in ESGE, USMSTF, and NCCN guidelines were met in 6.3, 9.4, and 30.4 per cent of patients respectively. Based on ESGE, USMSTF, and NCCN guidelines, colorectal cancer could potentially have been prevented in 41, 55, and 30.3 per cent of patients, and diagnosed earlier in 11, 14, and 21.1 per cent respectively. In ESGE guidelines, if surveillance had started 10 years before the youngest relative, there would be a significant increase in prevention (41 versus 55 per cent; P = 0.010).
Conclusion
ESGE, USMSTF, and NCCN criteria for familial colorectal cancer were met in 6.3, 9.4, and 30.4 per cent of patients with EOCRC respectively. In these patients, early detection and/or prevention could be achieved in 52, 70, and 51.4 per cent respectively. Early and accurate identification of familial colorectal cancer risk and increase in the uptake of early colonoscopy are key to decreasing familial EOCRC.
Funder
Instituto de Salud Carlos III European Regional Development Fund Agència de Gestió d’Ajuts Universitaris i de Recerca Generalitat de Catalunya
Publisher
Oxford University Press (OUP)
Cited by
4 articles.
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