Frequent Polyp Diagnoses in Relatives Linked to CRC Risk

TOPLINE:

Frequent colorectal polyp diagnoses in first- and second-degree relatives are associated with an increased risk for colorectal cancer (CRC), especially early-onset CRC.

METHODOLOGY:

• Researchers evaluated the association between the frequency of colorectal polyp diagnoses in relatives and the risk for overall and early-onset CRC using data from four Swedish family cancer datasets (1964-2018).
• A family history of colorectal polyp was defined as the presence of a record of polyp diagnosis in first- or second-degree relatives.
• In total, 11,676,043 individuals (median age, 49 years; 51% men) born after 1931 with at least one known first-degree relative were included; the median follow-up duration was 31 years.
• Relatives were categorized by whether they had one or frequent (two or more) colorectal polyp diagnoses and by their age at diagnosis.

TAKEAWAY:

• Compared with individuals with no family history, those with one first-degree relative with one polyp diagnosis had a 1.35-fold increased risk (95% CI, 1.32-1.38) for overall CRC.
• Individuals with one first-degree relative with frequent polyp diagnoses had a 2.27-fold increased risk for early-onset CRC (95% CI, 1.99-2.58) and a 1.82-fold increased risk for overall CRC (95% CI, 1.76-1.88).
• Those with more than two first-degree relatives with one polyp diagnosis had a 2.16-fold increased risk (95% CI, 1.55-2.93) for early-onset CRC, while individuals with relatives with frequent polyp diagnoses had a 3.92-fold increased risk (95% CI 2.83-5.30).
• In second-degree relatives, only frequent polyp diagnoses were associated with CRC risk.

IN PRACTICE:

“Our results suggest that screening guideline developers and clinicians should accurately recognize the elevated CRC risk in those with a family history of polyp, especially those with a family history of frequent polyp diagnoses, and develop tailored screening strategies for this population,” the authors wrote.

SOURCE:

This study was led by Yuqing Hu, MSc, of the National Center for Tumor Diseases, German Cancer Research Center in Heidelberg, Germany. It was published online in Gastroenterology.

LIMITATIONS:

This study lacked information on specific polyp characteristics, such as size, number, and histologic classification, limiting the assessment of their association with the risk for CRC. Potential confounders like smoking and physical activity were not adjusted for, and the sample size was limited in some subgroups, particularly second-degree relatives. In addition, this study spanned multiple generations of colonoscopy technology, which may have led to some unidentified polyps being included in the reference group.

DISCLOSURES:

One author was supported by the China Scholarship Council. None of the authors reported any relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.