Yield from colonoscopic screening in people with a strong family history of common colorectal cancer

Background and Aims: People with a strong family history of common (so-call ed 'sporadic') colorectal cancer are generally advised to undergo colonosco pic screening, but the starting age for this is unclear. An audit was perfo rmed to study the age-related yield of screening colonoscopy in this risk g roup. Methods: A prospective audit of the outcome of screening colonoscopy was pe rformed on a cohort of 232 people with a strong family history of common co lorectal cancer. All were registrants in a familial bowel cancer service so lely because of their family medical history. They had no bowel symptoms an d no prior endoscopic investigation of the large bowel. Results: Neoplastic lesions were detected by using colonoscopy in 33 partic ipants. In 27 participants, the major lesion was a small tubular adenoma, f our had an advanced adenoma and two had cancer. More neoplastic (P = 0.02) and advanced neoplastic (P = 0.03) lesions were found in those patients age d greater than or equal to 50 years. Only one advanced adenoma was detected in a participant below the age of 50 years. Conclusion: The yield from screening colonoscopy in young people (< 50 year s) with a strong family history of common colorectal cancer is low, placing doubt on the need for colonoscopic screening before the age of 50 years. ( C) 2000 Blackwell Science Asia Pty Ltd.