Hunt L M, Rooney P S, Hardcastle J D, Armitage N C
Department of Surgery, University of Nottingham, Queens Medical Centre, UK.
Gut. 1998 Jan;42(1):71-5. doi: 10.1136/gut.42.1.71.
The risk of colorectal cancer is higher among relatives of those affected. The neoplastic yield reported from screening such individuals varies enormously between studies and depends on the age and strength of the family history of those screened.
To ascertain the neoplastic yield of endoscopic screening of first degree relatives of patients with colorectal cancer by age and familial risk.
A total of 330 individuals with a family history of colorectal cancer.
Endoscopic screening conducted according to a protocol.
Adenomas were found in 12%, and adenomas larger than 1 cm in 8%, of "high risk" individuals screened primarily by colonoscopy. Of those with neoplasia, 26% had lesions at or proximal to the splenic flexure. Neoplasia was found in 9.5% of individuals at lower familial risk, screened primarily by 60 cm flexible sigmoidoscopy, 4% of whom had neoplasia larger than 1 cm in size or cancer. Neoplastic yield was greatest in the fourth and fifth decades in those at highest risk, but increased with age in those at lower risk.
For individuals with two or more first degree relatives, or relatives who have developed colorectal cancer at a young age, colonoscopy appears to be the only satisfactory method of screening, but 60 cm flexible sigmoidoscopy may be useful in those at lower levels of risk.
结直肠癌患者的亲属患癌风险更高。针对这些个体进行筛查的肿瘤检出率在不同研究中差异极大，且取决于被筛查者的年龄和家族病史强度。
根据年龄和家族风险确定对结直肠癌患者一级亲属进行内镜筛查的肿瘤检出率。
共有330名有结直肠癌家族史的个体。
按照方案进行内镜筛查。
主要通过结肠镜检查筛查的“高风险”个体中，12%发现腺瘤，8%发现直径大于1厘米的腺瘤。在有肿瘤的个体中，26%在脾曲或其近端有病变。主要通过60厘米可弯曲乙状结肠镜检查筛查的低家族风险个体中，9.5%发现肿瘤，其中4%的肿瘤直径大于1厘米或为癌症。高风险个体在第四和第五个十年的肿瘤检出率最高，但低风险个体的肿瘤检出率随年龄增加。
对于有两个或更多一级亲属，或亲属在年轻时患结直肠癌的个体，结肠镜检查似乎是唯一令人满意的筛查方法，但60厘米可弯曲乙状结肠镜检查对低风险个体可能有用。
