Feasibility study of colonoscopy as the primary screening investigation inrelatives of patients with colorectal cancer

Aim: Relatives of patients with colorectal. cancer are thought to be at a h igher risk for this disease than the average population. We aimed to determ ine whether colonoscopy is a feasible primary screening investigation for t his group to identify premalignant and malignant lesions. Methods: A total of 449 people underwent colonoscopy and all had one or mor e relatives with colorectal cancer. of these, 212 were classified as 'asymp tomatic' and 237 as being 'symptomatic'. Colonoscopy commenced at 40 years of age or 10 years younger than the youngest affected relative. Results: Neoplastic change, benign and malignant, was found in 25.5% of the 'asymptomatic' group and 24% of the 'symptomatic' group; in 26% of those w ith one first degree relative, 39% with two or more first degree relatives and only 19% with second degree relatives. 38% of lesions were out of reach of a flexible sigmoidoscope. No known complications occurred. Conclusions: It is feasible to perform colonoscopy as the primary investiga tion for the first degree relatives of patients with colorectal cancer. The yield of neoplastic lesions is sufficient to make this appropriate.