Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 7944-7953
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.7944
Familial colorectal cancer screening: When and what to do?
Giovanna Del Vecchio Blanco, Omero Alessandro Paoluzi, Pierpaolo Sileri, Piero Rossi, Giuseppe Sica, Francesco Pallone
Giovanna Del Vecchio Blanco, Omero Alessandro Paoluzi, Pierpaolo Sileri, Piero Rossi, Giuseppe Sica, Francesco Pallone, Department of Systems Medicine, Gastroenterology Unit, University Tor Vergata, 00133 Rome, Italy
Pierpaolo Sileri, Giuseppe Sica, Department of Surgery, University Tor Vergata, 00133 Rome, Italy
Piero Rossi, Department of Experimental Science and Surgery, University Tor Vergata, 00133 Rome, Italy
Author contributions: Del Vecchio Blanco G and Paoluzi OA designed and wrote the manuscript; Sileri P and Sica G reviewed the literature; Rossi P and Pallone F were involved in editing the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Giovanna Del Vecchio Blanco, Department of Systems Medicine, Gastroenterology Unit, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy. giovanna.del.vecchio.blanco@uniroma2.it
Telephone: +39-6-20900969 Fax: +39-6-20904437
Received: November 29, 2014
Peer-review started: November 29, 2014
First decision: February 10, 2015
Revised: March 4, 2015
Accepted: April 16, 2015
Article in press: April 17, 2015
Published online: July 14, 2015
Processing time: 227 Days and 7.1 Hours
Abstract

Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased risk of CRC development. In these individuals, screening is strongly recommended and should be started earlier than in the population with average risk, in order to detect neoplastic precursors, such as adenoma, advanced adenoma, and nonpolypoid adenomatous lesions of the colon. Fecal occult blood test (FOBT) is a non invasive, widespread screening method that can reduce CRC-related mortality. Sigmoidoscopy, alone or in addition to FOBT, represents another screening strategy that reduces CRC mortality. Colonoscopy is the best choice for screening high-risk populations, as it allows simultaneous detection and removal of preneoplastic lesions. The choice of test depends on local health policy and varies among countries.

Keywords: Colonoscopy; Colorectal cancer screening; Fecal occult blood test; Advanced adenoma; First-degree relative; Sigmoidoscopy

Core tip: One-fifth of people who develop colorectal cancer (CRC) have a first-degree relative (FDR) affected by this malignancy. Screening is an efficient method to reduce mortality for CRC and should be started in FDRs earlier than in the population at average risk. There is a large disparity in guidelines for screening in familial CRC, therefore, here we address the principal indication and methods for screening in this population at increased risk. Recent or emerging methods to improve the participation rate in screening programs are described. Ongoing trials on CRC screening are also reported.