Randomized Comparison of Surveillance Intervals in Familial Colorectal Cancer

Colonoscopic surveillance is recommended for individuals with familial colorectal cancer (CRC). However, the appropriate screening interval has not yet been determined. The aim of this randomized trial was to compare a 3-year with a 6-year screening interval. Individuals between ages 45 and 65 years...

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Bibliographic Details
Published in:	Journal of clinical oncology Vol. 33; no. 35; pp. 4188 - 4193
Main Authors:	Hennink, Simone D, van der Meulen-de Jong, Andrea E, Wolterbeek, Ron, Crobach, A Stijn L P, Becx, Marco C J M, Crobach, Wiet F S J, van Haastert, Michiel, Ten Hove, W Rogier, Kleibeuker, Jan H, Meijssen, Maarten A C, Nagengast, Fokko M, Rijk, Marno C M, Salemans, Jan M J I, Stronkhorst, Arnold, Tuynman, Hans A R E, Vecht, Juda, Verhulst, Marie-Louise, de Vos Tot Nederveen Cappel, Wouter H, Walinga, Herman, Weinhardt, Olaf K, Westerveld, Dik, Witte, Anne M C, Wolters, Hugo J, Cats, Annemieke, Veenendaal, Roeland A, Morreau, Hans, Vasen, Hans F A
Format:	Journal Article
Language:	English
Published:	United States 10-12-2015
Subjects:	Adenomatous Polyps - diagnosis Adenomatous Polyps - genetics Colonoscopy Colorectal Neoplasms - diagnosis Colorectal Neoplasms - genetics Colorectal Neoplasms - prevention & control Early Detection of Cancer Female Humans Male Middle Aged Population Surveillance - methods Risk Factors Time Factors
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Summary:	Colonoscopic surveillance is recommended for individuals with familial colorectal cancer (CRC). However, the appropriate screening interval has not yet been determined. The aim of this randomized trial was to compare a 3-year with a 6-year screening interval. Individuals between ages 45 and 65 years with one first-degree relative with CRC age < 50 years or two first-degree relatives with CRC were selected. Patients with zero to two adenomas at baseline were randomly assigned to one of two groups: group A (colonoscopy at 6 years) or group B (colonoscopy at 3 and 6 years). The primary outcome measure was advanced adenomatous polyps (AAPs). Risk factors studied included sex, age, type of family history, and baseline endoscopic findings. A total of 528 patients were randomly assigned (group A, n = 262; group B, n = 266). Intention-to-treat analysis showed no significant difference in the proportion of patients with AAPs at the first follow-up examination at 6 years in group A (6.9%) versus 3 years in group B (3.5%). Also, the proportion of patients with AAPs at the final follow-up examination at 6 years in group A (6.9%) versus 6 years in group B (3.4%) was not significantly different. Only AAPs at baseline was a significant predictor for the presence of AAPs at first follow-up. After correction for the difference in AAPs at baseline, differences between the groups in the rate of AAPs at first follow-up and at the final examination were statistically significant. In view of the relatively low rate of AAPs at 6 years and the absence of CRC in group A, we consider a 6-year surveillance interval appropriate. A surveillance interval of 3 years might be considered in patients with AAPs and patients with ≥ three adenomas.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0732-183X 1527-7755
DOI:	10.1200/JCO.2015.62.2035