Which first- degree relatives of patients with colorectal neoplasias are at the highest risk

Czech version

Authors: I. Mikoviny Kajzrlíková ¹; P. Vítek ^1,2; J. Chalupa ¹; P. Dítě ²
Authors‘ workplace: Beskydské Gastrocentrum Interního oddělení Nemocnice ve Frýdku– Místku, p. o., Frýdek– Místek, vedoucí Gastrocentra MU Dr. Petr Vítek, Ph. D. ¹; Katedra interních oborů Lékařské fakulty UO Ostrava, vedoucí katedry MU Dr. Ivo Valkovský ²
Published in: Vnitř Lék 2013; 59(4): 264-268
Category: Original Contributions

Předneseno nebo publikováno ve formě posteru: Rožnovské gastroenterologické dny, Rožnov pod Radhoštěm, 2011; Konference mladých lékařů, Brno, 2011; Dny mladých internistů, Olomouc, 2011; Kongres České gastroenterologické společnosti, Brno, 2011; Národní kongres o kolorektálním karcinomu, Praha, 2011; United European Gastroenterology week, Stockholm, 2011

Overview

Background and aims:
The first-degree relatives of patients with colorectal neoplasias have higher risk of colorectal cancer than general population. The aim of our study was to identify first- degree relatives at the highest risk of colorectal neoplasia considering both their hereditary and non‑hereditary risks.

Methods:
We have analysed the results of colonoscopic examinations of the first- degree relatives done within the project and we have compared them with the epidemiologic data relevant to colorectal cancer that we obtained from first-degree relatives.

Results:
160 first- degree relatives (66 men, 94 women, mean age 48.2, SD ± 10.9 years) have undergone colonoscopic examination within the project, 105 (66 %) of them had no or non‑neoplastic polyps, 55 (34 %) had neoplastic lesions. In the univariate analysis the risk factors for the occurence of neoplastic lesions were: male sex (OR 2.30, 95% CI 1.18– 4.48, p = 0.014), age over 50 years (OR 2.78, 95% CI 1.42– 5.45, p = 0.003), sibship (OR 2.71, 95% CI 1.25– 5.87, p = 0.012), smoking (OR 2.37, 95% CI 1.21– 4.63, p = 0.012) and higher fat intake (OR 2.07, 95% CI 1.07– 4.04, p = 0.032). In the multivariate analysis only the age over 50 years proved significant (OR 2.84, 95% CI 1.32– 6.09, p = 0.007). The most of the neoplastic lesions in first- degree relatives were located in the right colon.

Conclusions:
We can confirm high prevalence of neoplastic lesions among first- degree relatives. First-degree relatives at the highest risk are men over 50 years of age, siblings, smokers, who do not reduce dietary fat intake. This group of patients share both genetic and environmental risks and thus should be screened with the highest priority.

Key words:
colorectal cancer – first– degree relatives – dietary habits – risk factors

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