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Colon cancer screening practices after genetic counseling and testing for hereditary nonpolyposis colorectal cancer.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2004 Jan 01; Vol. 22 (1), pp. 39-44. - Publication Year :
- 2004
-
Abstract
- Purpose: Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common hereditary form of colon cancer. Cancer screening recommendations differ between individuals identified to carry an HNPCC mutation and those who do not carry a known family mutation. We assessed the impact of genetic counseling and testing (GCT) on the use of endoscopic screening procedures and adherence to recommended endoscopic screening guidelines in 56 asymptomatic at-risk individuals from families known to carry an HNPCC mutation.<br />Patients and Methods: We analyzed data on colonoscopy and flexible sigmoidoscopy screenings collected before GCT and 6 months and 12 months post-GCT on 17 mutation-positive and 39 true mutation-negative individuals. Main outcome measures were use of endoscopic screening and adherence to recommended guidelines for the relevant mutation status. Mutation status, age, sex, employment, and income were analyzed as predictor variables.<br />Results: Among mutation-negative individuals, use of colonoscopy and flexible sigmoidoscopy decreased significantly between pre- and post-GCT (P <.00001 and P <.0003, respectively). Among mutation-positive individuals, a nonsignificant increase (P =.24) in use was noted. Age was also associated with use of endoscopic screening after GCT (P =.03). Mutation status (odds ratio [OR], 7.5; P =.02) and employment (OR, 8.6; P =.025) were associated with nonadherence to endoscopic screening guidelines. More mutation-negative individuals strictly adhered to guidelines than did mutation-positive individuals (87% v 65%).<br />Conclusion: Genetic counseling and testing for HNPCC significantly influences the use of colonic endoscopy and adherence to recommendations for colon cancer screening.
- Subjects :
- Adult
Age Factors
Colorectal Neoplasms, Hereditary Nonpolyposis diagnosis
DNA Mutational Analysis
DNA, Neoplasm genetics
Female
Humans
Male
Mass Screening
Middle Aged
Patient Compliance
Prospective Studies
Colonic Neoplasms diagnosis
Colonic Neoplasms genetics
Colorectal Neoplasms, Hereditary Nonpolyposis genetics
Genetic Counseling
Genetic Testing
Guideline Adherence
Practice Guidelines as Topic
Sigmoidoscopy statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 22
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 14701766
- Full Text :
- https://doi.org/10.1200/JCO.2004.06.128