Public Release: 

Research calls for stricter screening recommendations for family history of colon cancer

If you have a close family member with colorectal cancer, don't delay screening

American Gastroenterological Association

Bethesda, MD (Oct. 6, 2015) -- All relatives of individuals with colorectal cancer are at increased risk for this cancer, regardless of the age of diagnosis of the index patient in the family, according to a study published online in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association. These findings may impact future guidance regarding colorectal cancer screening.

"Most surprising, we identified a more than two-fold increase in risk of colorectal cancer among young first-degree relatives (under 50 years of age) of individuals diagnosed with colorectal cancer at advanced ages (60 to 80 years)," said lead study author N. Jewel Samadder, MSc, MD, from Huntsman Cancer Institute at the University of Utah. "This risk is not currently appreciated. Increased awareness of this risk may serve as incentive to increase screening intensity for all patients with a first-degree family history of colorectal cancer."

The researchers conducted a population-based case-control study in Utah identifying 18,208 index patients from the Utah Cancer Registry diagnosed with colorectal cancer between 1980 and 2010; age- and sex-matched cancer-free individuals were selected to form the comparison group. Increased risk was observed in all relatives regardless of age of the family member's cancer diagnosis, although the risk was greatest for young relatives (under 50 years) of individuals who were diagnosed with colorectal cancer before 40 years of age. However, familial risk was increased in first-degree relatives even when the index case was diagnosed with cancer at an advanced age (older than 80 years).

These findings support the current screening guidelines for patients with a family history of colorectal cancer, primarily more aggressive screening for first-degree relatives of persons with colorectal cancer at an age younger than 60 years. However, because colorectal cancer diagnosis even in an older patient can be a predictor of higher risk of this cancer in their relatives, relatives might benefit from knowing this moderate risk and thus avoiding known modifiable risk factors and consider preventative measures.

Colorectal cancer is the fourth most common cancer in the U.S. and is the second leading cause of cancer-related mortality. Heritability is one of the strongest risk factors for colorectal cancer. Learn more in the AGA colorectal cancer patient brochure.


Review the AGA guidelines on screening for colorectal cancer and diagnosis and managemenet of Lynch syndrome, the most common heritable colorectal cancer syndrome.

The study authors disclose the following conflicts: Randall W. Burt is a consultant for Myriad Genetics. N. Jewel Samadder is a consultant for Cook Medical and Covidien Medical. Harminder Singh is consultant for Medial Cancer Screening Ltd. The remaining authors disclose no conflicts.

About the AGA Institute

The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization.

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit

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Samadder, N. J., Increased Risk of Colorectal Cancer Among Family Members of All Ages, Regardless of Age of Index Case at Diagnosis, Clinical Gastroenterology and Hepatology; 2015 advance online publication.;

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