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Family History as a Risk Factor for Colon Cancer-Data form the Community
Diabetes and risk for colorectal cancer
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Douglas J Sprung, MD,FACP,FACG Florida Hospital,Orlando,Fl
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dougjay54{at}hotmail.com Douglas J Sprung
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Eisen et al (1) state that the presence of a family history of colon cancer(FHCC) or adenomatous polyps(AP) increase the risk for CRC. In a study that we presented last year at the ACG meeting (2,3), data from a community bases private practice did not reveal a strong correlation with the accepted tenets as delineated by Eisen. Of 2167 patients undergoing colonoscopy,16% had AP's. 82% were <1cm size, 16% 1-2cm, and 2% were >2cm size. We found 20% (425) patients with FHCC; 30% of them had AP. OF the 12% (259)patients with FHCP (colon polyps) only 16% had AP. Of 425 patients with FHCC however,only (7)1.6%had colon cancer(CC). A FHCP (259 patients) yielded(7) or 2.7% with CC. The cohort without any FHCC or CP (1483), revealed (46) or 3.1% developed CC. This perplexing data complements our other published abstracts (4,5) showing a very low correlation between screening patients with FHCC and finding any cancers. It would be optimal if there was an initiative set forth by our national societies to press for more community studies as EMR becomes more popular. 1.Eisen GM,Weinberg DS. Narrative Review: Screening for Colorectal Cancer in Patients with a First- Degree Relative with Colonic Neoplasia. Ann Intern Med 2005;143:190-198. 2. Sprung DJ, Sprung GM. Colon Cancer in the Community: Occurence,Recurrence and Characteristics in a One Year Review. Amer J Gastro 2004:vol99, No 10, S106. 3. Sprung DJ,Sprung GM. Colonoscopy in the Community;Findings of a One Year Review. Amer J Gastro 2004;vol99,no 10, S324. 4. Sprung DJ, Apter MN.Utility of Surveillance Colonoscopy for Patients Whose First Degree Relatives Have Colon Cancer- a Community Based Study. Amer J Gastro 1997;Vol 92,No 9:1689. 5. Sprung DJ. Is Colon Cancer Surveillance Cost Effective for Asymptomatic Patients With a Positive Family History? Amer J Gastro 1998;Vol 93,No 9:1700. Conflict of Interest:None declared |
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Luca Mascitelli, MD Comando Brigata alpina, Francesca Pezzetta, MD
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lumasci{at}libero.it Luca Mascitelli, et al.
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TO THE EDITOR: Type 2 diabetes mellitus should be added to the risk factors for colorectal cancer (CRC) in the review by Eisen and Weinberg (1). Increasing evidence suggests that diabetes may increase the risk of CRC (2 -4). Furthermore, elevated glycated hemoglobin concentrations, even at levels below those used for diagnosis of diabetes, have been shown to be associated with increased CRC risk (5). Although it’s unclear whether diabetic status could change actual surveillance recommendation for screening of CRC, interventions intented to prevent abnormal glucose metabolism might reduce risk for CRC. Luca Mascitelli, MD Comando Brigata alpina “Julia” Udine, Italy 33100 Francesca Pezzetta, MD Ospedale di San Vito al Tagliamento San Vito al Tagliamento, Italy 33078 REFERENCES 1. Eisen GM, Weinberg DS. Narrative review: Screening for colorectal cancer in patients with a first-degree relative with colonic neoplasia. Ann Intern Med. 2005;143:190-8. 2. Will JC, Galuska DA, Vinicor F, Calle EE. Colorectal cancer: another complication of diabetes mellitus? Am J Epidemiol. 1998;147:816- 25. 3. Hu FB, Manson JE, Liu S, Hunter D, Colditz GA, Michels KB, et al. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst. 1999;91:542-7. 4. Larsson SC, Giovannucci E, Wolk A. Diabetes and colorectal cancer incidence in the cohort of Swedish men. Diabetes Care. 2005;28:1805-7. 5. Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N. Preliminary communication: glycated hemoglobin, diabetes, and incident colorectal cancer in men and women: a prospective analysis from the European prospective investigation into cancer-Norfolk study. Cancer Epidemiol Biomarkers Prev. 2004;13:915-9. Conflict of Interest:None declared |
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