Abstract
Purpose The identification of individuals with Hereditary Non Polyposis Colorectal Cancer (HNPCC) in the population is suboptimal. Causes include lack of physician recognition or failure to take an accurate family history. While colorectal cancer (CRC) in HNPCC is preventable by annual colonoscopy it is underutilized in part by lack of physician recommendation or poor understanding of personal risk of disease. We developed an online CRC risk assessment (http://www.clevelandclinic.org/score) incorporating family and personal history of adenomas and CRC which generated a pedigree, risk category and screening recommendations based on ACG guidelines. Modifiable lifestyle factors were also assessed and personalized recommendations were provided to minimize neoplasia due to those factors. We assessed the feasibility and online uptake of this tool and determined the proportion of high risk individuals who meet criteria suspicious for HNPCC. Methods The assessment included questions on demographics, use of previous CRC screening, and family and personal history of adenomas and CRC in 3 generations. Height, weight, age > or < 50, race, smoking exposure, physical activity, and dietary habits assessed. Risk categories included average, low, medium, and high.
Highlights
The identification of individuals with Hereditary Non Polyposis Colorectal Cancer (HNPCC) in the population is suboptimal
3515 participants completed the assessment. 67% male, 81% white and 46% were < age 50 with mean BMI of 28.4. 53% reported eating < 3 servings of fruits/vegetables daily and 45% didn’t exercise > 30 minutes > 3 days/week. 61% never smoked and 28% were former smokers. 39% reported previous screening; 89% utilizing colonoscopy. 11% reported a history of adenomas and 1.3% colorectal cancer (CRC)
The 405 individuals who reported a personal history of adenomas/CRC had a higher BMI 29.6 vs 28.1 (p= 0.013); Table 1 Risk Factors, Risk Category and Screening Recommendation
Summary
Carol A Burke*, Brandie Leach, Jie Dai, Nandan Patibandla, Elena Manilich, Margaret O’Malley, Lisa LaGuardia, Rocio Lopez, James Church. From 14th Annual Meeting of the Collaborative Group of the Americas on Inherited Colorectal Cancer Dallas, TX, USA. Purpose The identification of individuals with Hereditary Non Polyposis Colorectal Cancer (HNPCC) in the population is suboptimal. Causes include lack of physician recognition or failure to take an accurate family history. While colorectal cancer (CRC) in HNPCC is preventable by annual colonoscopy it is underutilized in part by lack of physician recommendation or poor understanding of personal risk of disease. We developed an online CRC risk assessment (http://www.clevelandclinic.org/score) incorporating family and personal history of adenomas and CRC which generated a pedigree, risk category and screening recommendations based on ACG guidelines.
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