From the Guidelines
If both of your parents had colon cancer, you should start screening at age 40 or 10 years before the youngest parent's diagnosis age, whichever comes first, with a colonoscopy every 5 years, as recommended by the U.S. Multi-Society Task Force on Colorectal Cancer 1. When considering the screening options, it's essential to note that the risk of colorectal cancer (CRC) is higher in individuals with a family history of the disease, especially if the relatives were diagnosed at a young age 1.
- The recommended screening method is a colonoscopy, which is the same as the average-risk screening recommendations, but with a more frequent interval due to the high-risk family history 1.
- It's also crucial to consider genetic counseling to determine if you have inherited a genetic syndrome like Lynch syndrome or familial adenomatous polyposis (FAP), which would require more intensive surveillance 1.
- In addition to screening, adopting lifestyle modifications can help reduce the risk of developing colorectal cancer, including:
- Maintaining a healthy weight
- Limiting red and processed meat consumption
- Increasing fiber intake through fruits and vegetables
- Exercising regularly (aim for 150 minutes per week)
- Avoiding smoking
- Limiting alcohol consumption These recommendations are based on your significantly increased risk of developing colorectal cancer compared to the general population, as having two first-degree relatives with colon cancer puts you at a higher risk 1. Early and regular screening can detect precancerous polyps or early-stage cancer when treatment is most effective, which can improve morbidity, mortality, and quality of life outcomes 1.
From the Research
Screening Recommendations for Individuals with a Family History of Colon Cancer
- Screening recommendations exist for individuals with a mild to moderate family history of colon cancer, with or without early age at onset 2
- For individuals with a defined susceptibility gene mutation, such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC), more specific screening recommendations are available 2
Chemoprevention Strategies
- Non-steroidal anti-inflammatory drugs, such as aspirin, have been shown to slow polyp progression in patients with FAP and HNPCC 3
- Low-dose aspirin has been found to reduce the long-term incidence of colorectal cancers 3, 4
- Other chemoprevention agents, such as cyclooxygenase 2 inhibitors, folic acid, statins, antioxidants, calcium, and 5-aminosalicylic acid, lack sufficient evidence to support their use 3
Combination of Chemoprevention and Colonoscopy
- Combination of aspirin and/or calcium chemoprevention with colonoscopy has been found to be cost-effective for primary prevention of colorectal cancer 5
- Aspirin and calcium supplementation may be beneficial when added to colonoscopy for optimum colorectal cancer prevention, at small incremental costs 5