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Weigl, Korbinian; Tikk, Kaja; Hoffmeister, Michael; Hampe, Jochen; Igel, Svitlana; Kolligs, Frank; Klug, Stefanie J.; Mansmann, Ulrich; Müller, Oliver; Nagel, Jutta M.; Pichler, Marcus; Schwab, Matthias; Schweigler, Dirk; Stephan, Anna-Magdalena; Toni, Enrico N. de; Brenner, Hermann (2019): Prevalence of a First-Degree Relative with Colorectal Cancer and Uptake of Screening Among Persons 40 to 54 Years Old. In: Clinical Gastroenterology and Hepatology [Forthcoming]
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Abstract

BACKGROUND People with a first-degree relative with colorectal cancer (CRC) are recommended to start CRC screening at age 40. However, there is limited information on how many people in different age groups have a known family history of CRC and how many of them have had a colonoscopy. METHODS We set up a multicenter cross-sectional population-based study in Germany to determine what proportions of persons in age groups from 40 to 54 years old have a known family history of CRC. We invited 160,000 persons to participate in an online survey from 2015 through 2016. We investigated what proportions of persons in each age group reported family history of CRC and what proportions of persons underwent colonoscopy examination using descriptive statistics and multiple logistic regression models. RESULTS Of 28,711 responders to the online questionnaire (8428 age 40-44 years, 9879 age 45-49 years, and 10,404 age 50-54 years), 2705 stated that they had first-degree relative with CRC (9.4%). The prevalence of a first-degree relative with CRC increased with age: 7.5%, 9.6%, and 10.9% for people 40-44 years old, 45-49 years old, and 50-54 years old, respectively. The prevalence of first-degree relative who received a diagnosis of CRC at age 70 years or older increased steadily with age group. Although a greater proportion of people with a family history of CRC had undergone colonoscopy examination (54.5%) than people without a family history of CRC (25.7%; P\textless.0001), large proportions of people within this risk group were not in compliance with the guidelines (54.8%, 47.6%, and 38.6% for ages 40-44 years, 45-49 years, and 50-54 years, respectively). CONCLUSION One in 10 persons in Germany age 40-54 years old has a first-degree relative with CRC. Guidelines recommend initiation of screening at ages 40-45 years for people with family history, yet at this age many people do not have a family history of CRC yet, and almost half of persons 40-54 years old with a family history of CRC have not yet received a screening colonoscopy.