Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Colorectal Dis. 2013 Apr;15(4):e175-85; discussion p.e185. doi: 10.1111/codi.12117.
Twelve to thirty % of colorectal cancer (CRC) patients and relatives with an increased familial risk of CRC are referred for preventive measures. New guidelines recommend genetic counselling for high-risk families and surveillance colonoscopy for moderate-risk families. Assessment of familial risk of CRC and referral rates for these preventive measures were determined 1 year after the introduction of new guidelines.
Assessment of familial risk of CRC and referral for preventive measures were measured in clinical practice among 358 patients with CRC in 18 hospitals using medical records and questionnaires. Additionally, a knowledge survey was performed among 312 clinicians.
Sixty-seven % of patients with an increased familial risk (n = 65/97) were referred for preventive measures, as were 23% (61/261) of low-risk patients. The uptake of genetic counselling in high-risk families was 33% (12/36). The uptake of surveillance colonoscopy in moderate-risk families was 34% (21/61). In the knowledge survey clinicians correctly determined familial risk in 55% and preventive measures in 65% of cases.
Currently 67% of individuals with an increased familial risk of CRC were referred for preventive measures. Only one-third were referred in accordance with guidelines.
12%至 30%的结直肠癌（CRC）患者和具有 CRC 家族高风险的亲属被转介进行预防措施。新指南建议对高风险家庭进行遗传咨询，并对中风险家庭进行监测结肠镜检查。在新指南实施 1 年后，评估了 CRC 的家族风险和这些预防措施的转介率。
在 18 家医院的 358 例 CRC 患者的临床实践中，使用病历和问卷评估了 CRC 的家族风险和预防措施的转介情况。此外，还对 312 名临床医生进行了知识调查。
67%（65/97）的高风险患者（n=65/97）和 23%（61/261）的低风险患者被转介进行预防措施。在高风险家庭中，遗传咨询的接受率为 33%（12/36）。在中风险家庭中，监测结肠镜检查的接受率为 34%（21/61）。在知识调查中，临床医生正确确定了 55%的家族风险和 65%的预防措施。
目前，67%的 CRC 家族高风险个体被转介进行预防措施。只有三分之一的患者符合指南的要求。
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