Plath Jasper, Siebenhofer Andrea, Koné Insa, Hechtner Marlene, Schulz-Rothe Sylvia, Beyer Martin, Gerlach Ferdinand M, Guethlin Corina
Institute of General Practice, Goethe-University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany,
German Cancer Research Center (DKFZ), Heidelberg, Germany.
Fam Pract. 2017 Feb;34(1):30-35. doi: 10.1093/fampra/cmw118. Epub 2016 Dec 5.
Evidence on the frequency of a positive family history of colorectal cancer (CRC) among individuals aged <55 years is lacking. General practice setting might be well suited for the identification of individuals in this above-average risk group.
To determine the frequency of a reported positive family history of CRC among patients aged 40 to 54 years in a general practice setting.
We conducted a cross-sectional study in 21 general practices in Germany. Patients aged 40 to 54 years were identified by means of the practice software and interviewed by health care assistants using a standardized four-item questionnaire. Outcome was occurrence of a positive family history of CRC, defined as at least one first-degree relative (FDR: parents, siblings, or children) with CRC. Further measurements were FDRs with CRC / colorectal polyps (adenomas) diagnosed before the age of 50 and occurrence of three or more relatives with colorectal, stomach, cervical, ovarian, urethel or renal pelvic cancer.
Out of 6723 participants, 7.2% (95% confidence interval [CI] 6.6% to 7.8%) reported at least one FDR with CRC and 1.2% (95% CI 0.9% to 1.5%) reported FDRs with CRC diagnosed before the age of 50. A further 2.6% (95% CI 2.3% to 3.0%) reported colorectal polyps in FDRs diagnosed before the age of 50 and 2.1% (95% CI 1.8% to 2.5%) reported three or more relatives with entities mentioned above.
One in 14 patients reported at least one FDR with CRC. General practice should be considered when defining requirements of risk-adapted CRC screening.
缺乏关于55岁以下人群结直肠癌(CRC)家族史阳性频率的证据。全科医疗环境可能非常适合识别这一高于平均风险组的个体。
确定在全科医疗环境中40至54岁患者报告的CRC家族史阳性频率。
我们在德国的21家全科诊所进行了一项横断面研究。通过诊所软件识别40至54岁的患者,并由医疗保健助理使用标准化的四项问卷进行访谈。结果是CRC家族史阳性的发生情况,定义为至少有一位一级亲属(FDR:父母、兄弟姐妹或子女)患有CRC。进一步的测量指标是50岁前被诊断为患有CRC/结直肠息肉(腺瘤)的FDR,以及有三位或更多亲属患有结直肠癌、胃癌、宫颈癌、卵巢癌、输尿管癌或肾盂癌。
在6723名参与者中,7.2%(95%置信区间[CI]6.6%至7.8%)报告至少有一位FDR患有CRC,1.2%(95%CI 0.9%至1.5%)报告50岁前被诊断为患有CRC的FDR。另外2.6%(95%CI 2.3%至3.0%)报告50岁前被诊断为患有结直肠息肉的FDR,2.1%(95%CI 1.8%至2.5%)报告有三位或更多亲属患有上述疾病。
每14名患者中就有1名报告至少有一位FDR患有CRC。在确定风险适应性CRC筛查的要求时应考虑全科医疗。