Adenomatous polyps in first-degree relatives of colon cancer patients
Abstract
Introduction: Colorectal cancer is currently the second most frequent neoplasm. Most of them are sporadic, another small proportion corresponds to hereditary forms. However, it is estimated that in 15-20% of cases there may be an associated hereditary component. First-degree relatives of patients with colorectal cancer constitute a universe with a higher risk of developing this disease than that of the general population, so screening is recommended in these individuals.
Objective: To determine the frequency of adenomatous polyps in individuals with first-degree relatives diagnosed with colon cancer.
Methods: A descriptive, cross-sectional study was carried out, including 126 adult relatives with first-degree blood relatives with colon cancer, who underwent colonoscopy at the Institute of Gastroenterology between December 2019 and December 2021. The characteristics of the adenomatous polyps found are described.
Results: The mean for age was 55.9 ± 10.6, women predominated: 94 (74.6 %). Thirty-nine (30.9 %) adenomatous polyps were found; 27 (69.2 %) were sessile and 12 (30.7 %) pedunculated; in 26 (66.7 %) the size was less than 10 mm. The majority, 37 (94.8 %), were of the tubular type. Diversity was observed as to the location of the lesions, with no predominance in any anatomical segment.
Conclusions: Precursor lesions of colorectal cancer, such as adenomatous polyps, are common in asymptomatic individuals with first-degree relatives who have had this malignancy.
DeCS: ADENOMATOUS POLYPOSIS COLI; ADENOMATOUS POLYPS; COLONIC NEOPLASMS; COLONOSCOPY; MASS SCREENING.
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References
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin [Internet]. 2021 [citado 29 Abr 2022];71(3):209-49. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.3322/caac.21660.
2. Global Cancer Observatory. Cancer Today [Internet]. 2020 [citado 16 Mar 2021]. Disponible en: https://gco.iarc.fr/today/.
3. American Cancer Society. Colorectal cancer facts & figures 2020–2022. Published online [Internet]. 2020 [citado 16 Mar 2021]. Disponible en: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf
4. Macrae F. Colorectal cancer: Epidemiology, risk factors, and protective factors. UpToDate [Internet]. 2019 [citado 2 Dic 2021]. Disponible en: http://www.uptodate.com/contents/colorectal-cancer-epidemiology-riskfactors-and-protective-factors/contributors?utdPopup=true/
5. Romero Rojas AE. Cáncer de colon y dieta. Rev Colomb Cancero [Internet]. 2015 [citado 05 Mar 2021];19(4):[aprox. 2 p.]. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-90152015000400001
6. Cuba. Ministerio de Salud Pública. Anuario estadístico de Cuba 2019 [Internet]. La Habana: Registros Médicos y Estadística de Salud; 2019 [citado 28 Dic 2020]. Disponible en: http://www.onei.gob.cu/sites/default/files/anauario_2019.pdf
7. Romero Pérez TC, Abreu Ruiz G, Monzón Fernández AN, Bermejo Bencomo W. Programa integral para el control del cáncer en cuba. Estrategia Nacional para el Control del Cáncer [Internet]. La Habana: Ecimed; 2017 [citado 18 Jun 2021]. Disponible en: https://www.paho.org/cub/index.php?option=com_docman&view=download&category_slug=documentacion-tecnica&alias=378-control-del-cancer-en-la-aps-experiencias-cubanas-2009&Itemid=226
8. Nguyen LH, Goel A ,Chung DC. Vías de carcinogénesis colorrectal. Gastroenterología [Internet]. 2020 [citado 15 de abril 2021];158(2):291-302. Disponible en : https://www.sciencedirect.com/science/article/abs/pii/S0016508519414418.
9. American Joint Committee on Cancer AJCC Cancer Staging Manual [Internet]. New York: Springer; 2017 [citado10 Ago 2021];471. Disponible en: https://www.cancer.org/es/cancer/cancer-decolon-o-recto/deteccion-diagnostico-clasificacion-por-etapas/clasificacion-de-la-etapa.html
10. Monreal-Robles R, Jáquez-Quintana JO, Benavides-Salgado DE, González-González JA. Pólipos serrados del colon y el recto: una revisión concisa. Revista de Gastroenterología de México [Internet]. 2021 [citado May 2021];86(3):276-86. Disponible en: https://www.sciencedirect.com/science/article/pii/S0375090621000446
11. Meester RGS, Doubeni CA, Lansdorp-Vogelaar I, Goede SL, Levin TR, Quinn VP, et al. Colorectal cancer deaths attributable to nonuse of screening in the United States. Ann Epidemiol [Internet]. 01 Mar 2015 [citado 29 Abr 2022];25(3):208-13. Disponible en: https://www.sciencedirect.com/science/article/pii/S1047279714005122
12. Levin TR, Corley DA, Jensen CD, Schottinger JE, Quinn VP, Zauber AG, et al. Efectos de la detección organizada del cáncer colorrectal en la incidencia y mortalidad del cáncer en una gran población comunitaria. Gastroenterología [Internet]. 2018 [citado May 2020];155(5):1383-91. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0016508518347838
13. Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al. WHO Classification of Tumours Editorial Board. The 2019 WHO classification of tumours of the digestive system. Histopathology [Internet]. Jan 2020 [citado May 2021];76(2):182-8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003895/
14. Mann R, Gajendran M, Umapathy C, Perisetti A, Goyal H, Saligram S, et al. Endoscopic Management of Complex Colorectal Polyps: Current Insights and Future Trends. Front Med [Internet]. 2022 [citado Ago 2022];8:728704. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8811151/
15. Código Internacional de Ética Médica. Adoptado por la 3ª Asamblea General de la AMM en Londres, Inglaterra, octubre 1949 y enmendado por la 22ª Asamblea Médica Mundial. Sídney, Australia, agosto 1968 y la 35ª [Internet]. Venecia: Asamblea Médica Mundial; 1983 [citado 18 Ago 2021]. Disponible en: http://www.wma.net/s/policy/pdf/17a.pdf
16. Asociación Médica Mundial. Declaración de Helsinki de la AMM – Principios éticos para las investigaciones médicas en seres humanos [Internet]. France: AMM; 2017 [citado 22 Oct 2021]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/
17. Song M, Emilsson L, Roelstraete B, Ludvigsson JF. Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden. BMJ [Internet]. 04 May 2021 [citado 29 Abr 2022];373:n877. Disponible en: https://www.bmj.com/content/373/bmj.n877
18. Del Vecchio Blanco G, Cretella M, Paoluzi OA, Caruso A, Mannisi E, Servadei F, et al. Adenoma, advanced adenoma and colorectal cancer prevalence in asymptomatic 40- to 49-year-old subjects with a first-degree family history of colorectal cancer. ColorectalDis [Internet]. Sep 2013 [citado 29 Abr 2022];15(9):1093-9. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1111/codi.12263
19. Huang RL, Liu Q, Wang YX, Zou JY, Hu LF, Wang W, et al. Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study. BMJ Open [Internet]. 01 Jul 2021 [citado 29 Abr 2022];11(7):e045168. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276297/
20. Lynch KL, Ahnen DJ, Byers T, Weiss DG, Lieberman DA. First-degree relatives of patients with advanced colorectal adenomas have an increased prevalence of colorectal cancer. Clin Gastroenterol Hepatol [Internet]. 01 Mar 2003 [citado 29 Abr 2022];1(2):96-102. Disponible en: http://www.scopus.com/inward/record.url?scp=0141996275&partnerID=8YFLogxK
21. Armelao F, Orlandi PG, Tasini E, Franceschini G, Franch R, Paternolli C, et al. High uptake of colonoscopy in first-degree relatives of patients with colorectal cancer in a healthcare region: a population-based, prospective study. Endoscopy [Internet]. Ene 2010 [citado 29 Abr 2022];42(1):15-21. Disponible en: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0029-1215324
22. Menges M, Fischinger J, Gärtner B, Georg T, Woerdehoff D, Maier M, et al. Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study. Int J ColorectalDis [Internet]. 01 May 2006 [citado 29 Abr 2022];21(4):301-7. Disponible en: https://doi.org/10.1007/s00384-005-0032-2
23. Puente Gutiérrez JJ, Marín Moreno MA, Domínguez Jiménez JL, Bernal Blanco E, Díaz Iglesias JM. Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer. Colorectal Dis [Internet]. 2011 [citado 29 Abr 2022];13(6):e145-53. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1463-1318.2011.02577.x.
24. Samadder NJ, Curtin K, Tuohy TMF, Rowe KG, Mineau GP, Smith KR, et al. Increased Risk of Colorectal Neoplasia Among Family Members of Patients With Colorectal Cancer: A Population-Based Study in Utah. Gastroenterology [Internet]. 01 Oct 2014 [citado 29 Abr 2022];147(4):814-21. Disponible en: https://www.gastrojournal.org/article/S0016-5085(14)00902-0/fulltext?referrer=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
25. Lowery JT, Ahnen DJ, Schroy PC, Hampel H, Baxter N, Boland CR, et al. Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review [Internet]. 2016 [citado 04 May 2020];122(17):2633-45. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27258162/
26. Li P, Li S, Chen J, Shao L, Lu X, Cai J. Association between family history and prognosis of patients with colorectal cancer: a systematic review and meta-analysis. Transl Cancer Res [Internet]. Ene 2022 [citado 29 Abr 2022];11(1). Disponible en: https://tcr.amegroups.com/article/view/59657
27. Lee SY, Song WH, Oh SC, Min BW, Lee SI. Anatomical distribution and detection rate of colorectal neoplasms according to age in the colonoscopic screening of a Korean population. Ann SurgTreat Res [Internet]. 2018 [citado 14 Jun 2020];94(1):36-43. Disponible en: https://synapse.koreamed.org/articles/1095219
28. Robertson DJ, Ladabaum U. Opportunities and Challenges in Moving From Current Guidelines to Personalized Colorectal Cancer Screening. Gastroenterology [Internet]. 2019 [citado 14 Jun 2021];156(4):904-917. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30593801/
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