Risks of Colorectal Neoplasia Based on Family History of CRC

Substantial evidence links a family history of colorectal cancer (CRC) in first-degree relatives to an increased risk of CRC, but its association with other types of colorectal neoplasia is less clear, wrote the authors of a study published in The American Journal of Gastroenterology.

A comprehensive search of PubMed, Web of Science, and Embase databases was conducted through May 2024, focusing on observational studies. The analysis included data on adenomas, nonadvanced adenomas (NAA), advanced adenomas (AA), and advanced neoplasia (AN) as key outcomes. A random-effects model was used for data synthesis, and subgroup meta-analyses were performed to test the robustness of the findings.

From an initial pool of 5172 records, 75 studies encompassing 931,515 participants were analyzed. The findings indicated that a family history of CRC in first-degree relatives was significantly associated with a higher risk of adenomas (pooled odds ratio [OR] 1.67), NAA (OR 1.35), AA (OR 1.66), and AN (OR 1.58). The associations remained consistent across all subgroups. Notably, individuals with 2 or more affected first-degree relatives had a higher risk of adenoma (OR 4.18), AA (OR 2.42), and AN (OR 2.00).

These results underscore the strong link between family history of CRC and various colorectal neoplasia types, reinforcing the need for intensified screening strategies for individuals with affected first-degree relatives. This has implications for health resource allocation and policy development aimed at early detection and prevention of colorectal neoplasia.

Reference

Gao K, Jin H, Yang Y, et al. Family history of colorectal cancer and the risk of colorectal neoplasia: a systematic review and meta-analysis. The American Journal of Gastroenterology. Published online October 9, 2024. doi:https://doi.org/10.14309/ajg.0000000000003120