• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
Br J Gen Pract. Apr 2004; 54(501): 267–271.
PMCID: PMC1314851

Improving the ascertainment of families at high risk of colorectal cancer: a prospective GP register study.

Abstract

BACKGROUND: Screening for colorectal cancer is effective in family members with a high risk of this condition, owing to single gene mutations. However, it is not known which is the most effective method of ascertaining these families at high risk. AIMS: To investigate whether a case-finding approach using computerised general practitioner (GP) registers would improve the ascertainment of families at high risk of colorectal cancer due to family history. DESIGN OF STUDY: Prospective GP register study. SETTING: General practices in Oxfordshire. METHOD: Identification of patients with colorectal cancer using GP registers, followed by a family history questionnaire survey to identify those at high risk. RESULTS: Using GP registers, 758 patients with a diagnosis of colorectal cancer were identified; a prevalence of 172 cases per 100 000 (95% confidence interval = 159 to 184). Of these, 305 patients, diagnosed under the age of 65 years, were sent a family history questionnaire. Two hundred and one (66%) patients responded to the survey; 10 (5%) patients were assessed as having high-risk families and 47 (23%) patients were assessed as having families at moderate risk. Eight of the high-risk patients had 34 first degree relatives who would benefit from routine disease surveillance, and 37 moderate-risk patients had 153 first degree relatives. Only two high-risk and six moderate-risk patients identified were previously known to the local Clinical Genetics Department. CONCLUSION: A case-finding approach using GP records and a family history questionnaire is an effective way of identifying families at high risk of developing colorectal cancer, who can then be offered disease surveillance.

Full Text

The Full Text of this article is available as a PDF (39K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Emery J, Watson E, Rose P, Andermann A. A systematic review of the literature exploring the role of primary care in genetic services. Fam Pract. 1999 Aug;16(4):426–445. [PubMed]
  • Emery J, Rose P. Expanding the role of the family history in primary care. Br J Gen Pract. 1999 Apr;49(441):260–261. [PMC free article] [PubMed]
  • Summerton N, Garrood PV. The family history in family practice: a questionnaire study. Fam Pract. 1997 Aug;14(4):285–288. [PubMed]
  • House W, Sharp D, Sheridan E. Identifying and screening patients at high risk of colorectal cancer in general practice. J Med Screen. 1999;6(4):205–208. [PubMed]
  • Leggatt V, Mackay J, Yates JR. Evaluation of questionnaire on cancer family history in identifying patients at increased genetic risk in general practice. BMJ. 1999 Sep 18;319(7212):757–758. [PMC free article] [PubMed]
  • Järvinen HJ, Aarnio M, Mustonen H, Aktan-Collan K, Aaltonen LA, Peltomäki P, De La Chapelle A, Mecklin JP. Controlled 15-year trial on screening for colorectal cancer in families with hereditary nonpolyposis colorectal cancer. Gastroenterology. 2000 May;118(5):829–834. [PubMed]
  • Neil HA, Hammond T, Huxley R, Matthews DR, Humphries SE. Extent of underdiagnosis of familial hypercholesterolaemia in routine practice: prospective registry study. BMJ. 2000 Jul 15;321(7254):148–148. [PMC free article] [PubMed]
  • Marks Dalya, Wonderling David, Thorogood Margaret, Lambert Helen, Humphries Steve E, Neil H Andrew W. Cost effectiveness analysis of different approaches of screening for familial hypercholesterolaemia. BMJ. 2002 Jun 1;324(7349):1303–1303. [PMC free article] [PubMed]
  • Vasen HF, Watson P, Mecklin JP, Lynch HT. New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology. 1999 Jun;116(6):1453–1456. [PubMed]
  • Hodgson SV, Bishop DT, Dunlop MG, Evans DG, Northover JM. Suggested screening guidelines for familial colorectal cancer. J Med Screen. 1995;2(1):45–51. [PubMed]
  • Marteau TM, Bekker H. The development of a six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992 Sep;31(Pt 3):301–306. [PubMed]
  • Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–218. [PubMed]
  • Micheli A, Mugno E, Krogh V, Quinn MJ, Coleman M, Hakulinen T, Gatta G, Berrino F, Capocaccia R. Cancer prevalence in European registry areas. Ann Oncol. 2002 Jun;13(6):840–865. [PubMed]
  • Kerber RA, Slattery ML. Comparison of self-reported and database-linked family history of cancer data in a case-control study. Am J Epidemiol. 1997 Aug 1;146(3):244–248. [PubMed]
  • Farrington SM, Lin-Goerke J, Ling J, Wang Y, Burczak JD, Robbins DJ, Dunlop MG. Systematic analysis of hMSH2 and hMLH1 in young colon cancer patients and controls. Am J Hum Genet. 1998 Sep;63(3):749–759. [PMC free article] [PubMed]
  • Tomlinson IP, Beck NE, Homfray T, Harocopos CJ, Bodmer WF. Germline HNPCC gene variants have little influence on the risk for sporadic colorectal cancer. J Med Genet. 1997 Jan;34(1):39–42. [PMC free article] [PubMed]
  • Emery J, Hayflick S. The challenge of integrating genetic medicine into primary care. BMJ. 2001 Apr 28;322(7293):1027–1030. [PMC free article] [PubMed]
  • Rose PW, Watson E, Yudkin P, Emery J, Murphy M, Fuller A, Lucassen A. Referral of patients with a family history of breast/ovarian cancer--GPs' knowledge and expectations. Fam Pract. 2001 Oct;18(5):487–490. [PubMed]
  • Watson E, Clements A, Yudkin P, Rose P, Bukach C, Mackay J, Lucassen A, Austoker J. Evaluation of the impact of two educational interventions on GP management of familial breast/ovarian cancer cases: a cluster randomised controlled trial. Br J Gen Pract. 2001 Oct;51(471):817–821. [PMC free article] [PubMed]
  • Rose P, Humm E, Hey K, Jones L, Huson SM. Family history taking and genetic counselling in primary care. Fam Pract. 1999 Feb;16(1):78–83. [PubMed]
  • Leggatt V, Mackay J, Marteau TM, Yates JR. The psychological impact of a cancer family history questionnaire completed in general practice. J Med Genet. 2000 Jun;37(6):470–472. [PMC free article] [PubMed]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...