Current Screening Recommendations Research Articles

Epidemiology of pancreatic cancer.

Cancer of the pancreas remains one of the deadliest cancer types. Based on the GLOBOCAN 2012 estimates, pancreatic cancer causes more than 331000 deaths per year, ranking as the seventh leading cause of cancer death in both sexes together. Globally, about 338000 people had pancreatic cancer in 2012, making it the 11th most common cancer. The highest incidence and mortality rates of pancreatic cancer are found in developed countries. Trends for pancreatic cancer incidence and mortality varied considerably in the world. A known cause of pancreatic cancer is tobacco smoking. This risk factor is likely to explain some of the international variations and gender differences. The overall five-year survival rate is about 6% (ranges from 2% to 9%), but this vary very small between developed and developing countries. To date, the causes of pancreatic cancer are still insufficiently known, although certain risk factors have been identified, such as smoking, obesity, genetics, diabetes, diet, inactivity. There are no current screening recommendations for pancreatic cancer, so primary prevention is of utmost importance. A better understanding of the etiology and identifying the risk factors is essential for the primary prevention of this disease.

Patient Test Preference for Colorectal Cancer Screening and Screening Uptake in an Insured Urban Minority Population.

The study examines the role of patient colorectal cancer (CRC) screening test preference and CRC screening uptake in an insured, urban minority population. Study subjects were enrolled in a randomized controlled trial to promote CRC screening. The interventions were educational, with an emphasis on colonoscopy screening. Subjects were 50+years of age, fully insured for CRC screening, and out of compliance with current CRC screening recommendations. This paper includes those who answered a question about CRC screening test preference and indicated that they intended to receive such a test in the coming year (n=453). CRC screening uptake was ascertained from medical claims data. Regardless of test preference, few received CRC screening (22.3%). Those preferring the home stool test (HST) were less likely to get tested than those preferring a colonoscopy (16.6 vs 29.9%, χ(2)=9.9, p=.002). Preference for HST was more strongly associated with beliefs about colonoscopy than with knowledge about colonoscopy. In the context of an RCT emphasizing colonoscopy screening for CRC, patients expressing a preference for HST are at heightened risk of remaining unscreened. Colonoscopy should be recommended as the preferred CRC test, but HSTs should be accessible and encouraged for patients who are averse to colonoscopy.Clinical trials.gov: Identifier: NCT02392143.

Discontent and Confusion: Primary Care Providers' Opinions and Understanding of Current Cervical Cancer Screening Recommendations.

In 2012, new cervical cancer screening guidelines were published by three widely recognized entities which advocate delayed onset of testing, fewer screenings, selective use of human papilloma virus co-testing, and no further screening in women over age 65 years. Early observations report that these recommendations are not being followed and overscreening is common. This study seeks to understand why primary care providers might not adhere to these new 'best practice' health policy protocols. A total of 4,909 randomly selected primary care providers (physicians, nurse practitioners, and physician assistants) practicing in California were mailed a study questionnaire. Participants were asked if they consider current published screening guidelines to be authoritative, reliable, and/or clinically appropriate. Clinical vignettes captured individual provider beliefs on timing and method of cervical cancer screening in women within the four key age groups embedded in current screening guidelines. Of the 4,909 surveys mailed, 1,268 (25.8%) qualified responses were received. Fundamentally, 35.0% of all primary care providers do not believe current guidelines are clinically appropriate, with 58.6% of obstetrician/gynecologist physicians having this same skepticism. Even among those who affirmatively believe current guidelines are authoritative, reliable, and clinically appropriate, only 15.3% recommend screening intervals and methodology of testing in women of four differing ages consistent with that of current policy guidelines. Among the primary care providers surveyed, distrust and confusion likely limit adherence to current evidence-based cervical cancer screening health policy recommendations, and contribute to the current high rates of overscreening that have been observed.

Limitations of Current AHA Guidelines and Proposal of New Guidelines for the Preparticipation Examination of Athletes.

To examine the prevalence of athletes who screen positive with the preparticipation examination guidelines from the American Heart Association, the AHA 12-elements, in combination with 3 screening electrocardiogram (ECG) criteria. Observational cross-sectional study. Stanford University Sports Medicine Clinic. Total of 1596 participants, including 297 (167 male; mean age, 16.2 years) high school athletes, 1016 (541 male; mean age, 18.8 years) collegiate athletes, and 283 (mean age, 26.3 years) male professional athletes. Athletes were screened using the 8 personal and family history questions from the AHA 12-elements. Electrocardiograms were obtained for all participants and interpreted using Seattle criteria, Stanford criteria, and European Society of Cardiology (ESC) recommendations. Approximately one-quarter of all athletes (23.8%) had at least 1 positive response to the AHA personal and family history elements. High school and college athletes had similar rates of having at least 1 positive response (25.9% vs 27.4%), whereas professional athletes had a significantly lower rate of having at least 1 positive response (8.8%, P < 0.05). Females reported more episodes of unexplained syncope (11.4% vs 7.5%, P = 0.017) and excessive exertional dyspnea with exercise (11.1% vs 6.1%, P = 0.001) than males. High school athletes had more positive responses to the family history elements when compared with college athletes (P < 0.05). The percentage of athletes who had an abnormal ECG varied between Seattle criteria (6.0%), Stanford criteria (8.8%), and ESC recommendations (26.8%). Many athletes screen positive under current screening recommendations, and ECG results vary widely by interpretation criteria. In a patient population without any adverse cardiovascular events, the currently recommended AHA 12-elements have an unacceptably high rate of false positives. Newer screening guidelines are needed, with fewer false positives and evidence-based updates.

Acceptability of Physician Directed Academic Detailing to Increase Colorectal Cancer Screening: an Application of the RESPECT Approach.

Background: In developing effective interventions to increase colorectal cancer (CRC) screening in at risk populations, a necessary first requirement is feasibility. This paper describes how the RESPECT approach to health education guided the conceptualization and implementation of physician-directed academic detailing (AD) to increase practice-wide CRC screening uptake. Methods: Physician-directed AD was one intervention component in a large educational randomized controlled trial to increase CRC screening uptake. Study participants, primarily urban minority, were aged 50 or older, insured for CRC screening with no out-of-pocket expense and out of compliance with current screening recommendations. The trial was conducted in the New York City metropolitan area. Participants identified their primary care physician; 564 individuals were recruited, representing 459 physician practices. Two-thirds of the physician practices were randomized to receive AD. The RESPECT approach, modified for AD, comprises: 1) Rapport, 2) Educate, but don’t overwhelm, 3) Start with physicians where they are, 4) Philosophical orientation based on a humanistic approach to education, 5) Engagement of the physician and his/her office staff, 6) Care and show empathy, and 7) Trust. Feasibility was assessed as rate of AD delivery. Results: The AD was delivered to 283 (92.5%) of the 306 practices assigned to receive it; 222/283 (78.4%) delivered to the doctor. Conclusion: The AD was feasible and acceptable to implement across a range of clinical settings. The RESPECT approach offers a framework for tailoring educational efforts, allowing flexibility, as opposed to strict adherence to a highly structured script or a universal approach.

Multicenter Evaluation of Current Knowledge of Hepatitis C Screening Recommendations Among Trainee Physicians

Introduction: Hepatitis C (HCV) is a significant burden within the United States, with the Center for Disease Control and Prevention (CDC) estimating 3.2 million individuals chronically infected. Newer therapies for HCV have brought hope for a significant percentage of these patients with rates of cure over 90% among approved regimens. In 2012, the CDC set forth guidelines for screening for HCV. We sought to identify understanding of CDC recommendations amongst primary care residents in the United States. Methods: A web-based survey was used to gauge understanding of current CDC screening recommendations. The survey included basic demographic data such as gender, residency in internal medicine or family medicine, and current level of training. The survey was sent to all primary care residents within the Henry Ford Health System and to Internal Medicine residency program directors throughout the United States through the ACGME list-server with request to be distributed to their residents. Results: 186 responses were received. 58.8 were male and 98.2% were internal medicine residents. Level of training was evenly split, with 34.6% PGY1, 33.3% PGY2, and 30.9% PGY3. 59.8% of respondents have received formal education regarding screening guidelines in their residency program. 69.5% of respondents stated they screened every patient born from 1945-65 at least once for HCV. Amongst the groups currently recommended for screening, 95.7% of residents recognized the role for screening in history of injected drug use, 70.6% in long-term hemodialysis patients, 92% in patients with HIV, and 95.7% in healthcare workers after sharps exposure or mucosal exposure to HCV-positive blood. There was a broad spread of understanding of current cure rates for HCV, with 13.9% of respondents believing the cure rate was 90%. Limited provider time was the most significant obstacle to screening patients born between 1945 and 1965 for HCV (68.7%). Conclusion: Our findings indicate good understanding of current CDC recommendations for HCV screening. There is room for improvement in follow-through with actual screening. There is poor understanding of the efficacy of current available therapies for HCV. This may reflect a lack of formal education in regards to HCV screening and treatment. Our study is limited by low response rate, especially among family medicine residents.

Breast cancer screening utilization and understanding of current guidelines among rural U.S. women with private insurance.

Women living in rural areas of the U.S. face disparities in screening mammography and breast cancer outcomes. We sought to evaluate utilization of mammography, awareness of screening guidelines, and attitudes towards screening among rural insured U.S. women. We conducted a cross-sectional self-administered anonymous survey among 2000 women aged 40-64 insured by the National Rural Electric Cooperative Association, a non-profit insurer for electrical utility workers in predominantly rural areas across the U.S. Outcomes included mammographic screening in the past year, screening interval, awareness of guidelines, and perceived barriers to screening. 1588 women responded to the survey (response rate 79.4 %). 74 % of respondents lived in a rural area. Among women aged 40-49, 66.5 % reported mammographic screening in the past year. 46 % received annual screening, 32 % biennial screening, and 22 % rare/no screening. Among women aged 50-64, 77.1 % reported screening in the past year. 63 % received annual screening, 25 % biennial screening, and 12 % rare/no screening. The majority of women (98 %) believed that the mammography can find breast cancer early and save lives. Less than 1 % of younger women, and only 14 % of women over age 50 identified the recommendations of the U.S. Preventative Services Screening Task Force as the current expert recommendations for screening. Screening practices tended to follow perceived guideline recommendations. When rural U.S. women over age 40 have insurance, most receive breast cancer screening. The screening guidelines of cancer advocacy groups and specialty societies appear more influential and widely recognized than those of the U.S. preventative services taskforce.

S07.3 Facilitating sexual health: why do 12–16 year olds attend a rural sexual health clinic?

Introduction Chlamydia is the most commonly diagnosed bacterial STI in Australia and is asymptomatic in approximately 80% of people. If untreated, potential consequences include pelvic inflammatory disease, ectopic pregnancy and infertility. Those experiencing recurrent infections are more likely to experience these unwanted complications, and as such consideration must be given to those who are very young when first infected. Methods In 2014 we undertook a retrospective audit at a rural sexual health service to determine what proportion of patients attending the clinic were aged 12–16 years, tested for and infected with chlamydia and their reasons for attending the clinic. Results There were 595 consultations for patients aged 12–16 years during the study period, with a total of 111 individual patients attending the clinic, 104 (95%) were female. 194 chlamydia tests were conducted with the proportion of individual patients having at least one test per year being 100% in 2011, 81% in 2012, 72% in 2013 and 78% in 2014. There was no difference in the proportion tested by age over the study period (p = 0.59). 46 tests were positive for chlamydia (23.7%; 95% CI: 17.8%, 30.9%) with the proportion decreasing with increasing age from 46.7% (95% CI: 16.4%, 79.5%) in those aged 12 or 13 years to 15.5% (95% CI: 9.4%, 24.2%) in those age 16 years (p = 0.02). The reasons for attending the clinic when a chlamydia test was ordered included i) pregnancy testing, request for emergency contraception and/or termination of pregnancy (18.3%, 34/185), ii) symptoms of anything (16.7%, 31/185), iii) a request for STI screening or treatment (32.4%, 60/185) and presenting for contraception (32.4%, 60/185). Only 29.7% (33/111) of these patients would have tested for chlamydia if symptoms or requesting a screen were the only reasons a test was ordered. Conclusion Consideration should be given to amending the current chlamydia screening recommendation to annual screening of any sexually active person under 29 years. Conflict of interest None declared.

Fetal interrupted aortik ark tip B’nin antenatal değerlendirilmesi

Interruption of the aortic arch (IAA) is a rare, severe form of congenital heart defect characterized by complete anatomical discontinuity between two adjacent segments of the aortic arch. The data on the features and outcomes of fetal IAA are limited. Three anatomical types have been described according to the site of interruption. The current recommendations for screening on the obstetric fetal anomaly scan include identification of a 4-chamber view, all 4 valves, and the outflow tracts, all of which can appear to be normal to the ultrasonographer in fetuses with conotruncal anomalies. Although the identification of IAA on a prenatal echocardiogram can be challenging, a number of anatomic features can facilitate the diagnosis. We aim to present the features and outcome of a case of IAA type B referred to our centre in the light of literatures

The effects of glucose-lowering therapies on diabetic kidney disease.

Chronic hyperglycemia and its associated metabolic products are key factors responsible for the development and progression of diabetic chronic kidney disease (CKD). Endocrinologists are tasked with detection and management of early CKD before patients need referral to a nephrologist for advanced CKD or dialysis evaluation. Primary care physicians are increasingly becoming aware of the importance of managing hyperglycemia to prevent or delay progression of CKD. Glycemic control is an integral part of preventing or slowing the advancement of CKD in patients with diabetes; however, not all glucose-lowering agents are suitable for this patient population. The availability of the latest information on treatment options may enable physicians to thwart advancement of serious renal complication in patients suffering from diabetes. This review presents clinical data that shed light on the risk/benefit profiles of three relatively new antidiabetes drug classes, the dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 analogs, and sodium glucose co-transporter 2 inhibitors, particularly for patients with diabetic CKD, and summarizes the effects of these therapies on renal outcomes and glycemic control for endocrinologists and primary care physicians. Current recommendations for screening and diagnosis of CKD in patients with diabetes are also discussed.

Current Cervical Carcinoma Screening Guidelines.

A formidable threat to the health of women, cervical carcinoma can be prevented in many cases with adequate screening. The current guidelines for cervical carcinoma screening were created as joint recommendations of the American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Society for Clinical Pathology (ASCP) in 2012, and later accepted and promoted by the American Congress of Obstetricians and Gynecologists (ACOG). The 2012 recommendations underscore the utility of molecular testing as an adjunct to cytology screening for certain women and provide guidance to clinicians based on different risk-benefit considerations for different ages. This manuscript will review screening techniques and current recommendations for cervical cancer screening and human papilloma virus (HPV) testing, as well as possible future screening strategies.

Portal Hypertension and Variceal Hemorrhage

Gastrointestinal bleeding in patients with cirrhosis can occur from a number of different causes, including portal hypertension, gastric antral vascular ectasia, and acute variceal hemorrhage. The management of these conditions involves a combined medical and endoscopic approach, with radiologic and surgical therapies restricted to refractory cases. This review covers the natural history of gastroesophageal varices, portal hypertensive gastropathy, and gastric antral vascular ectasia; diagnostic principles; primary and secondary prophylaxis relating to esophageal variceal hemorrhage; and treatment overviews for gastric variceal hemorrhage, portal hypertensive gastropathy, and gastric antral vascular ectasia. Figures show the pathophysiology of complications of cirrhosis, esophageal varices as seen during an upper endoscopic procedure, natural history of esophageal varices in patients with cirrhosis, portal hypertensive gastropathy, gastric antral vascular ectasia, and management principles for acute variceal hemorrhage, esophageal variceal ligation, and gastric varices. Tables list the prevalence of various etiologies of hemorrhage in patients with cirrhosis, current recommendations for follow-up screening and surveillance of varices, sensitivities and specificities of some noninvasive markers, and principles of initial management of acute variceal hemorrhage. This review contains 8 highly rendered figures, 4 tables, and 44 references.

The recommended interval for cervical cancer screening: Victorian women's attitudes to an extended interval

AimTo determine Victorian women's knowledge of the recommended Pap test screening interval and support for extending the interval from two years to three years, in light of possible changes to the National Cervical Screening Program. MethodsA random sample of 2,360 women aged 18–69 was interviewed by telephone about their knowledge of the recommended interval, their willingness to change to three‐yearly screening if recommended and reasons for their preference. ResultsMore than 91% of women were aware of the current screening recommendation and nearly half (48.7%) indicated they would be willing to change to three‐yearly screening. Women were less likely to support the change if they were up‐to‐date with screening (45.7%, p<0.01), of low socioeconomic status (43.8%, p<0.01) or aged 50–69 (44.4%, p<0.01). Dislike of having a Pap test was reason for some women to want a longer interval, but most needed to be confident a longer interval was safe to be willing to change. Conclusions and implicationsA longer interval between screening tests would readily be accepted by some women, but others will need to be persuaded of the safety of a new recommendation. The current interval is widely known and a clear communication strategy will be needed explain the change and its rationale.

Screening for Asymptomatic Extragenital Gonorrhea and Chlamydia in Men Who Have Sex with Men: Significance, Recommendations, and Options for Overcoming Barriers to Testing

Men who have sex with men (MSM) have a disproportionately greater risk than other populations of acquiring Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), the two most commonly reported notifiable diseases in the United States according to the Centers for Disease Control and Prevention (CDC). The presence of either of these diseases is a significant risk factor for the acquisition and transmission of human immunodeficiency virus (HIV). Recent studies have shown that significant rates of asymptomatic GC and CT infection are found at the extragenital oropharygeal and rectal sites in MSM, with or without concurrent urogenital infection. However, extragenital sites are not being routinely screened and, thus, many asymptomatic GC and CT infections at the oropharyngeal and rectal sites may go undiagnosed. This review will begin with the current evidence-based screening recommendations for extragenital GC and CT in MSM. This will be followed by recently reported extragenital GC and CT infection rates in asymptomatic MSM, and a discussion of the risks and potential implications of undiagnosed extragenital GC and CT infections. Finally, a discussion on the frequency of, and potential barriers to, screening will be presented with a summary of potential interventions for increasing screening frequency found in the literature. The scope of this review will focus primarily on U.S. recommendations, infection rates, and screening frequencies, with the inclusion of relevant international recommendations and studies for comparative and illustrative purposes.

Ability of community-based prostate cancer screening to target an appropriate and underserved population.

Screening is not universally beneficial due to over- and under-diagnosis, and false positives that beget additional testing and associated adverse events and expense. We examined data from all men who participated in a mass community prostate cancer screening between May 2009 and September 2010. The data contained information regarding patient demographics, family history of prostate cancer, lower urinary tract symptoms, prior history of prostate cancer, most recent digital rectal examination, and the presence of an established relationship with a physician. Current American Urological Association screening recommendations were then applied to determine the appropriateness of our outreach effort. A total of 438 men (mean age 66.5 years) underwent screening. A total of 106 (24.2%) patients in our study met contemporary criteria for screening. Of these men, the vast majority was well educated, well insured, and well informed about the need for prostate cancer screening. Based on these data, mass community-based prostate cancer screening does not appear to identify and screen at-risk men. Future efforts at mass screening should more carefully target men most likely to benefit.

Selective ultrasound screening is inadequate to identify patients who present with symptomatic adult acetabular dysplasia.

PurposeOne goal of neonatal screening for developmental dysplasia of the hip (DDH) is the prevention of late surgery. However, the majority of patients with acetabular dysplasia at skeletal maturity are not diagnosed with DDH during infancy. Selective ultrasound screening may identify patients with neonatal hip instability, but may be ineffective for the prevention of dysplasia presenting in adulthood. The purpose of this study is to identify the prevalence of risk factors for DDH that would have warranted selective ultrasound screening in patients with symptomatic acetabular dysplasia after skeletal maturity.MethodsA prospective hip specialty center registry was used to identify 68 consecutive skeletally mature patients undergoing corrective osteotomy for symptomatic acetabular dysplasia. Risk factors for DDH evaluated in all patients included sex, family history of hip osteoarthritis or DDH, breech, method of delivery, previous hip treatments, and birth order. Radiographs [lateral center edge angle (CEA), anterior CEA, Tönnis grade, and Tönnis angle] were measured preoperatively.ResultsSixty-seven females and one male were identified. No patients were previously diagnosed with DDH or received treatment for their hips. The majority of patients (85.3 %) did not meet selective ultrasound screening guidelines following a stable neonatal hip exam and, therefore, would not have been screened in a selective screening program. Of the findings outside of screening guidelines, 98.5 % were females, 52.9 % were first born, and 36.8 % had a family history of hip osteoarthritis.ConclusionsThe majority (85.3 %) of patients with symptomatic acetabular dysplasia at skeletal maturity would not have met current recommendations for selective ultrasound screening in the USA had they been born today.

A community-based intervention in middle schools to improve HPV vaccination and cervical cancer screening in Japan

AimJapan has low rates of cervical cancer screening and Human papilloma virus (HPV) vaccination. This research examines the effectiveness of a family medicine resident-led, intervention in increasing knowledge about HPV and cervical cancer in middle school-girls and increasing knowledge and intention to have cervical cancer screening in their mothers.MethodsWe utilized a pre-test/post-test intervention design in three rural middle schools with 7th grade middle school-girls and their mothers. A school-based activity educated girls about HPV and cervical cancer. A home-based activity utilized a homework assignment for girls and their mothers. Pre/post intervention surveys were completed by the girls and their mothers. Major outcomes included changes in knowledge among girls and mothers and barriers to be screened for cervical cancer among mothers.ResultsSixty-five students and sixty-three mothers completed the study. Two out five mothers were not in compliance with current screening recommendations. Identified barriers included: embarrassment (79%), poor access (56%), fear of having cancer (52%), and cervical cancer screening being an unknown procedure (46%). Forty-four percent of mothers deemed their daughters to be at risk for cervical cancer. Trusted sources of information included: doctors (97%), newspapers/television (89%), government (79%), the Internet (78%), and friends (62%). Student knowledge scores (7-point scale) improved significantly from pre- to post-intervention (4.8 vs. 5.9, p < 0.001). Knowledge scores (14-point scale) among mothers also significantly improved (11.7 vs. 12.0, p = 0.024).ConclusionsThese data suggest a community-based intervention on a sensitive topic by family medicine residents can be implemented in middle schools, can improve school-girls’ knowledge about HPV and cervical cancer, and can reach their mothers. Additional research could examine whether those intending to be screened receive screening and how to reach women who still resist screening.

CRC Screening Remains the Most Effective Prevention Tool

Global cancer prevention experts, gastrointestinal cancer physicians, and researchers attended the International Society of Cancer Prevention consensus conference to discuss the current science of colorectal cancer (CRC) carcinogenesis, screening, and preventive intervention; to develop a consensus statement encompassing current recommendations for CRC screening, genetic assessment, and cancer prevention interventions; and to further delineate knowledge gaps that need to be addressed in future CRC prevention research. This article presents the highlights from the CRC prevention consensus meeting.

Prognostic value of C-reactive protein and lactic dehydrogenase and hemoglobin in advanced non small cell lung cancer

databases, including the PLCO and LLP. These risk assessments have been validated between the ages of 65 and 75 years for PLCO, and 65 and 79 years for LLP. Use of this individual risk assessment may identify appropriate screening populations not included in current lung cancer screening recommendations.

Abstract 2921: Assessing colorectal cancer risk using known genetic susceptibility variants and family history accounting for endoscopy

Abstract Colorectal cancer (CRC) is one of the most commonly diagnosed cancers, and remains the second leading cause of cancer death, despite the fact that rates have declined and that being among the most preventable of cancers. Current screening recommendations are based only on age, family history of CRC, and previous screening results, whereas risk varies substantially in the population and most cases occur in those without a positive family history. The recent substantial progress in identifying CRC associated common genetic variants has offered new opportunities to refine risk-prediction models and provide more accurate risk stratification for those at risk. We developed risk-prediction models for men and women based on age, family history, and 28 CRC-associated common genetic variants identified to date, accounting for history of endoscopy, in 5,811 cases and 6,302 controls, and validated the models in an independent study of 866 cases and 869 controls. The genetic risk score derived from CRC-associated common variants provides an independent risk predictor and significantly improves the discriminatory accuracy over the model that includes only family history for both men (AUC = 0.60 vs. 0.51, p-value = 4.6e-6) and women (AUC=0.57 vs. 0.52, p-value=0.02). Including the genetic risk score may also improve risk stratification. Considering, for example, the average 10-year risks of 60-year-old men (2.68%) and women (1.49%) in the absence of endoscopy as the thresholds for screening, then the age to start screening for men with positive family history would be 54, and 61 years old otherwise. For women the starting age would be 57 and 61 years old, respectively. Including additional genetic variants information leads to a wider range, from 51 years old for those with positive family history and the genetic risk scores at the 90% to 68 years old for those without positive family history and the genetic risk scores at the 10%. For women, the range would be from 53 years old to 66 years old, respectively. We also derived estimates of 10-year absolute risk for men and women given their age, family history status, risk alleles carried, and endoscopy. To illustrate, for a 60-year-old man who does not have positive family history, but who carries 28 risk alleles (top 20%), and has not had an endoscopy, risk for developing CRC is 5.49% (95% CI, 3.63 to 7.35); however, if he has undergone endoscopy, his risk is reduced to 1.67% (95% CI, 1.10 to 2.25). For a 60-year-old woman who has a similar profile, risk of developing CRC is 2.41% (95% CI, 1.98 to 2.83) in the absence of endoscopy and is reduced to 1.23% (95% CI, 1.00 to 1.46) if she has undergone endoscopy. Our development and validation of a risk-prediction model are first steps towards utilizing genetic information for more tailored screening and prevention strategies, which should improve the cost-effectiveness of screening and, perhaps, adherence. Citation Format: Li Hsu, Jihyoun Jeon, Hermann Brenner, Sonja Berndt, Andrew T. Chan, Jenny Chang-Claude, Stephen B. Gruber, Tabitha Harrison, Michael Hoffmeister, Polly Newcomb, John Potter, Fredrick Schumacher, Martha Slattery, Duncan Thomas, Emily White, Yingye Zheng, Ulrike Peters, Colorectal Transdisciplinary Study; Genetics and Epidemiology of Colorectal Cancer Consortium. Assessing colorectal cancer risk using known genetic susceptibility variants and family history accounting for endoscopy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2921. doi:10.1158/1538-7445.AM2014-2921