Screening results in a family cancer clinic: five years experience

Abstract

We present our experience so far of screening individuals referred to the Cancer family clinic at St. Mark's Hospital from 1986, with the results of the follow-up of these individuals. 651 individuals from 436 families were offered colonoscopic surveillance at five-yearly intervals. The median age at which the examination was performed was 41 years. Families were subdivided according to family history; 15.8% conformed to the Amsterdam criteria for hereditary nonpolyposis colorectal cancer (HNPCC). The pathological findings were correlated with the type of pedigree; abnormalities were more often found in males than females (30% of colonoscopies in males revealed adenomas, and 17% in females), and adenoma prevalence increased with age. Adenoma prevalence (27% v.s. 21% at all ages, and 38% v.s. 25% in individuals over the age of 35y.), multiple adenomas and the proportion of proximally sited adenomas were all higher in HNPCC families; however, dysplasia and villous or large adenomas were not more common in individuals from HNPCC families. Four of the 7 carcinoma detected were in HNPCC families (3% v.s. 0.6%).