TY - JOUR
T1 - Increased Risk of Colorectal Cancer Tied to Advanced Colorectal Polyps
T2 - An Untapped Opportunity to Screen First-Degree Relatives and Decrease Cancer Burden
AU - Kolb, Jennifer M.
AU - Molmenti, Christine L.
AU - Patel, Swati G.
AU - Lieberman, David A.
AU - Ahnen, Dennis J.
N1 - Publisher Copyright:
© 2020 by The American College of Gastroenterology.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Advanced adenomas represent a subset of colorectal polyps that are known to confer an increased risk of colorectal neoplasia to the affected individual and their first-degree relatives (FDRs). Accordingly, professional guidelines suggest earlier and more intensive screening for FDRs of those with advanced adenomas similar to FDRs of those with colorectal cancer (CRC). Although the risk to family members is less clear among patients with advanced serrated polyps, they are often considered in the same category. Unfortunately, there is a growing concern that patients, endoscopists, and primary care providers are unaware of the familial risk associated with these polyps, leaving a wide gap in screening these high-risk individuals. Herein, we propose a standardized language around advanced colorectal polyps and present a detailed review of the literature on associated familial risk. We outline the challenges to implementing the current screening recommendations and suggest approaches to overcome these limitations, including a proposed new colonoscopy quality metric to capture communication of familial CRC risk. Improving screening in these high-risk groups has the potential to substantially reduce the burden of CRC.
AB - Advanced adenomas represent a subset of colorectal polyps that are known to confer an increased risk of colorectal neoplasia to the affected individual and their first-degree relatives (FDRs). Accordingly, professional guidelines suggest earlier and more intensive screening for FDRs of those with advanced adenomas similar to FDRs of those with colorectal cancer (CRC). Although the risk to family members is less clear among patients with advanced serrated polyps, they are often considered in the same category. Unfortunately, there is a growing concern that patients, endoscopists, and primary care providers are unaware of the familial risk associated with these polyps, leaving a wide gap in screening these high-risk individuals. Herein, we propose a standardized language around advanced colorectal polyps and present a detailed review of the literature on associated familial risk. We outline the challenges to implementing the current screening recommendations and suggest approaches to overcome these limitations, including a proposed new colonoscopy quality metric to capture communication of familial CRC risk. Improving screening in these high-risk groups has the potential to substantially reduce the burden of CRC.
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U2 - 10.14309/ajg.0000000000000639
DO - 10.14309/ajg.0000000000000639
M3 - Review article
C2 - 32618646
AN - SCOPUS:85087472115
SN - 0002-9270
VL - 115
SP - 980
EP - 988
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
IS - 7
ER -