Colonoscopic screening of XXXX with suspected risk factors for colon cancer. I. Family history.

@entity1 @entity652 @entity5 @entity14
A family history of @entity14 is believed to place @entity1 at increased risk for development of the disease. It is unclear, however, how "strong" a family history must be to increase this risk or to make colonoscopic screening appropriate. We performed initial colonoscopy in 154 asymptomatic subjects whose only suspected risk factor was one or two first-degree relatives with @entity14 ; 48 of these subjects also had affected second- and third-degree relatives. We found 45 @entity652 in 28 subjects (18%). One subject had a 3-cm villous adenoma. In 6 subjects, the most advanced findings were tubular @entity652 5-9 mm in diameter; in 21 subjects, we found only tubular @entity652 that were 2-4 mm in diameter. The prevalence of @entity652 increased significantly with age of subjects (p less than 0.01). Although the overall prevalence of @entity14 in our group was no greater than might be expected in the general population, subjects with two first-degree relatives tended to have more diminutive @entity652 than those with one such relative. Our findings suggest that colonoscopy is not an appropriate first step in screening @entity1 with one affected first-degree relative. For those with more complex family histories, more data are needed--particularly on the prevalence of advanced @entity5 --to determine whether a screening technique that is less costly and less invasive than colonoscopy may be adequate.
