Risk-adapted prevention strategies for colorectal cancer

First-degree relatives of a patient with colorectal cancer have a two to four times increased risk of being diagnosed with this cancer. Therefore, these people are recommended to undergo screening colonoscopy already at age 40. However, very limited information has been available about the proportion of people with such family history and their use of colonoscopy. The RAPS study aimed to assess how many people aged 40-54 have a known family history of colorectal cancer and how many of them have had a colonoscopy. 

Of 160,000 persons invited to participate in an online survey in 2015 and 2016 in this multi-centric study (München, Dresden, Stuttgart), 28,711 completed the questionnaire. 2705 persons (9.4%) stated that they had a first-degree relative with colorectal cancer. The proportion of people with a first-degree relative with colorectal cancer increased with age: 7.5%, 9.6%, and 10.9% for people 40-44, 45-49, and 50-54 years, respectively. Although a higher proportion of people with a family history of colorectal cancer had undergone a colonoscopy (54.5%) than people without a family history (25.7%), almost half of people with a family history were not in compliance with the guidelines.

The RAPS study provides novel and urgently needed results for further improvement of colorectal cancer prevention in Germany: 1 in 10 persons in Germany aged 40-54 years has a first-degree relative with colorectal cancer. Strategies are needed to increase adherence to recommendations of early use of screening colonoscopy in this high risk group.

Publications

(1) Weigl K, Tikk K, Hoffmeister M, Hampe J, Igel S, Kolligs F, Klug SJ, Mansmann U, Müller O, Nagel JM, Pichler M, Schwab M, Schweigler D, Stephan AM, De Toni EN, Brenner H. Prevalence of a First-Degree Relative With Colorectal Cancer and Uptake of Screening Among Persons 40 to 54 Years Old. Clin Gastroenterol Hepatol 2020;18(11):2535-2543

(2) Weigl K, Tikk K, Hoffmeister M, De Toni EN, Hampe J, Kolligs F, Klug SJ, Mansmann U, Nasseh D, Radlovic J, Schwab M, Schweigler D, Stephan AM, Brenner H. A Web-based survey among adults aged 40-54 years was time effective and yielded stable response patterns. J Clin Epidemiol 2019;105:10-18

(3) Tikk K, Weigl K, Hoffmeister M, Igel S, Schwab M, Hampe J, Klug SJ, Mansmann U, Kolligs F, Brenner H. Study protocol of the RaPS study: novel risk adapted prevention strategies for people with a family history of colorectal cancer. BMC Cancer 2018;18(1):720