Family intestinal polyps link to colorectal cancer

A new link has been found between colorectal polyps in close relatives and individual risk of colorectal cancer.

Identifying high risk individuals for tailored screening – for colorectal polyps – is important for improving the prevention of colorectal cancer, say Dr Mingyang Song and colleagues at Harvard Medical School, Boston, MA, USA.

It has been unclear whether people with a family history of colorectal polyps have an increased risk of colorectal cancer, so the team examined the possible link using figures on 68,060 patients in Sweden.

This showed that having a first degree relative with a colorectal polyp was linked to a 40% increased risk of colorectal cancer. This ranged from a 23% raised risk for hyperplastic polyps to 44% for tubulovillous adenomas.

"The association between family history of polyps and colorectal cancer risk was strengthened by the increasing number of first degree relatives with polyps," the researchers add in yesterday’s (4 May) BMJ.

They conclude: "After adjusting for family history of colorectal cancer, the siblings and children of patients with colorectal polyps are still at higher risk of colorectal cancer, particularly early onset colorectal cancer.

"Early screening for colorectal cancer might be considered for first degree relatives of patients with polyps," they urge.

Dr Song commented: “The risk was double in people with at least two first-degree relatives with polyps or a first-degree relative who had a colorectal polyp diagnosed before the age of 60.”

Co-author Dr Jonas Ludvigsson added: “If additional studies reveal a link between a family history of polyps and the risk of colorectal cancer, it is something to take into account in the screening recommendations, especially for younger adults.

“I really hope that this study can help doctors in Sweden and elsewhere identify patients at a higher risk of colorectal cancer.”

Song, M. et al. Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden. BMJ 4 May 2021 doi: 10.1136/bmj.n877

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