Descriptive analysis of endoscopic findings in patients with a family history of colorectal cancer

BackgroundThe presence of a family history implies an increased risk for developing colorectal cancer (CRC), and may require a different screening strategy.The aim of this study was to evaluate lesions found during colonoscopies of patients that had a family history of CRC.Material and methodsA retrospective study was conducted that included consecutive colonoscopies performed on patients with a family history of CRC at a referral center within the period from April 2000 to January 2012. The colonoscopic findings were analyzed in relation to sex, age, and the presence or absence of symptoms.ResultsData from 3,792 colonoscopies were collected. The mean age of the patients was 53.14 years (SD 12.22), and 57.4% were women. Colonoscopy was normal in 71.7% of the cases, with hyperplastic polyps being detected in 7.1%, and adenomatous polyps in 19.8% (39.4% of them were high risk). There was a 1.5% presence of adenocarcinomas in the subjects. Polyps and CRC were predominant in men (P=.001 and P=.027, respectively) and there was a linear increase with age. Symptomatic patients had a higher CRC detection rate (P<.001), but no differences were observed in relation to polyp diagnosis.ConclusionsAge and male sex increased the risk for presenting with CRC or adenomas in the group of patients with a family history of CRC, and the presence of symptoms was associated with a greater risk for presenting with CRC.

ResumenAntecedentesLa presencia de antecedentes familiares implica un riesgo aumentado de presentar colorrectal (CCR), lo que condiciona una estrategia de cribado diferente.El objetivo de este trabajo fue evaluar las lesiones halladas en las colonoscopias de pacientes que se sometieron a esta exploración y que tuvieron antecedentes familiares para CCR.Material y métodosSe realizó un estudio retrospectivo incluyendo las colonoscopias consecutivas realizadas en un centro de referencia desde abril del 2000 hasta enero del 2012 en pacientes con antecedentes familiares de CCR. Los hallazgos encontrados en la colonoscopia se analizaron en función del sexo, la edad y la presencia o ausencia de síntomas.ResultadosSe recogieron datos de 3,792 colonoscopias. La edad media ± desviación estándar de los pacientes fue de 53.14 ± 12.22 años, siendo el 57,4% mujeres. La colonoscopia fue normal en el 71.7% de los casos, se detectaron pólipos hiperplásicos en el 7.1% y pólipos adenomatosos en el 19.8% (39.4% de ellos, de alto riesgo). La presencia de adenocarcinomas se evidenció en el 1.5% de los sujetos. La presencia de pólipos y CCR predomina en varones (p = 0.001 y p = 0.027, respectivamente) y aumentan de forma lineal con la edad. En los pacientes sintomáticos hubo mayor tasa de detección de CCR (p < 0.001), mientras que no se observaron diferencias para el diagnóstico de pólipos.ConclusionesEn el grupo de pacientes con antecedentes familiares de CCR, la edad y el sexo masculino aumentan el riesgo de presentar CCR o adenomas. La presencia de síntomas se asocia a mayor riesgo de presentar CCR.