High-risk colorectal cancer patients lack knowledge about prevention

Sept. 17, 2020

Researchers from Florida Atlantic University’s (FAU) Schmidt College of Medicine found that more than a quarter of patients at high-risk for colorectal cancer (28.6 percent) were unaware of either the need for a repeat colonoscopy or the proper surveillance interval, according to a press release from the university.

Of those patients who were unaware of standard prevention recommendations, 16.6 percent were unaware of the proper three-year interval to obtain a follow-up surveillance colonoscopy, while 12 percent were not even aware that they required a follow-up surveillance colonoscopy.

In a study published in the Journal of Gastroenterology and Digestive Systems, the researchers analyzed data over a period of four years from 2013 to 2017 to explore the knowledge of these high-risk patients. They analyzed data from structured interviews on 84 subjects between ages 40 to 91 years old with biopsy-proven advanced colorectal polyps.

Colorectal cancer is the third most common cause of cancer deaths in the United States and advanced colorectal polyps are a major risk factor. These high-risk patients have a three-fold higher risk of developing colorectal cancer, and therefore, a three-year follow up interval of colonoscopy is generally recommended. Many clinicians rely on self-reports from their high-risk patients about their need and proper interval for repeat surveillance colonoscopy.

“Our data raise a challenge for us to rely on more objective data than self-reports. Clinicians should have the ability and willingness to share their objective findings with all clinical colleagues involved in the care of the patient,” said Lawrence Fiedler, MD, co-author, a gastroenterologist and an affiliate associate professor in FAU’s Schmidt College of Medicine.

Screening modalities for colorectal cancer include fecal immune testing, multi-targeted stool DNA testing, flexible sigmoidoscopy and colonoscopy.

The incidence of colorectal cancer is increasing in younger people. According to the American Cancer Society, from 2007 to 2016, incidence rates of colorectal cancer in people 55 years or older dropped by 3.6 percent each year but increased by 2 percent each year in those younger than 55.

According to the U.S. Centers for Disease Control and Prevention, additional risk factors include inflammatory bowel disease such as Crohn’s disease or ulcerative colitis; a personal or family history of colorectal cancer or colorectal polyps; and a genetic syndrome such as familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome).

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