PURPOSE: The objective of our investigation was to attempt to address the controversial issue concerning index screening and surveillance of relatives of patients with colorectal cancer and to identify those areas of research that should be considered in future studies. METHODS: Relevant literature was reviewed concerning the screening of asymptomatic first-degree relatives of patients with colorectal cancer not associated with the rare autosomal dominant inherited colorectal cancer syndromes. RESULTS: The data reviewed suggest that there is an increased risk of colorectal neoplasia in this population and a significantly higher yield of adenomas and carcinomas when colonoscopy is used for index screening. However, significant variability in study design and screening protocols and inconsistencies in data presentation make clinical interpretation and data analysis confusing and difficult. CONCLUSIONS: There is a critical need for standardization in future studies. Furthermore, as there are no studies that document decreased overall mortality from colorectal cancer in first-degree relatives as a result of screening, the decision as to whether to screen this population needs to be based on future prospective controlled trials.

Should relatives of patients with colorectal cancer be screened? A critical review of the literature.

A recent examination of the time trends in colorectal cancer incidence and mortality in the USA from 1950 through 1990 reveals declining mortality rates in the late 1980s (Chu et al 1994). In that survey, as well as in other recent data discussed in Chapter 22, a greater detection rate at earlier stages of colorectal cancer suggests that the increased use of fecal occult blood testing and sigmoidoscopy leading to colonoscopy, has already played a role in reducing mortality from colorectal cancer in the USA.

Screening for Colorectal Tumors

The Value of Colonoscopic Screening in Patients with a Family History of Colon and Rectal Neoplasia.

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The Value of Colonoscopic Screening in Patients with a Family History of Colon and Rectal Neoplasia.