Prevention of colorectal cancer by colonoscopic surveillance in individuals with a family history of colorectal cancer: 16 year, prospective, follow-up study

Introduction We report the outcomes of a long-term surveillance programme for individuals with a family history of colorectal cancer. Methods The details of patients undergoing a colonoscopy having been referred on the basis of family history of colorectal cancer were entered prospectively into a database. Further colonoscopy was arranged on the basis of the findings. The outcomes assessed included incidence of cancer and adenoma identification at initial and subsequent colonoscopy. Results The records of 2,293 patients (917 men; median patient age: 51 years) were entered over 22 years, giving data on 3,982 colonoscopies. Eight adverse events (0.2%) were recorded. Twenty-seven cancers were found at first colonoscopy and thirteen developed during the follow-up period. There were significantly more cancers identified in those with more than one first-degree relative with cancer than in other groups (p=0.01). The number of adenomas identified at subsequent surveillance colonoscopies remained constant with between 9.3% and 12.0% of patients having adenomas that were removed. Two-thirds (68%) of patients with cancer and three-quarters (77%) with adenomas fell outside the British Society of Gastroenterology (BSG) 2006 guidelines. Conclusions Repeated colonoscopy continues to yield significant pathology including new cancers. These continue to occur despite removal of adenomas at prior colonoscopies. The majority of patients with cancers and adenomas fell outside the BSG 2006 guidelines; more would have fallen outside the 2010 guidelines.

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The Role of Phonological Working Memory and Environmental Factors in Lexical Development in Italian-Speaking Late Talkers: A One-Year Follow-Up Study

Journal of Speech Language and Hearing Research ◽

10.1044/2017_jslhr-l-15-0415 ◽

2017 ◽

Vol 60 (12) ◽

pp. 3462-3473 ◽

Cited By ~ 6

Author(s):

Andrea Marini ◽

Milena Ruffino ◽

Maria Enrica Sali ◽

Massimo Molteni

Keyword(s):

Working Memory ◽

Family History ◽

Home Literacy Environment ◽

Home Literacy ◽

Semantic Fluency ◽

Literacy Environment ◽

Follow Up Study ◽

Late Talkers ◽

History Of

Purpose This follow-up study assessed (a) the influence of phonological working memory (pWM), home literacy environment, and a family history of linguistic impairments in late talkers (LTs); (b) the diagnostic accuracy of a task of nonword repetition (NWR) in identifying LTs; and (c) the persistence of lexical weaknesses after 10 months. Method Two hundred ninety-three children were assessed at approximately 32 (t1) and 41 (t2) months. At t1, they were administered the Italian adaptation of the Language Development Survey, an NWR task (used to assess pWM), and questionnaires assessing home literacy environment and family history of language impairments. Thirty-three LTs were identified. The linguistic skills of the participants were evaluated at t2 by administering tasks assessing Articulation, Naming, Semantic Fluency, and Lexical Comprehension. Results At t2, LTs performed more poorly as compared with age-matched typically developing peers in articulatory and naming skills, had reduced lexical comprehension abilities, and had limited lexical knowledge. Their performance on the NWR task at t1 correlated with the extension of their vocabularies at t2 (as estimated with a Semantic Fluency task). Conclusions The Language Development Survey recently adapted to Italian is sensitive to LTs. Former LTs still have a mild lexical delay at approximately 40 months. As an indirect measure of pWM, the task of NWR is an early indicator of future lexical deficits.

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Frequency of replication errors in colorectal cancer and their association with family history

Gut ◽

10.1136/gut.43.4.553 ◽

1998 ◽

Vol 43 (4) ◽

pp. 553-557 ◽

Cited By ~ 6

Author(s):

S R Brown ◽

P J Finan ◽

L Cawkwell ◽

P Quirke ◽

D T Bishop

Keyword(s):

Colorectal Cancer ◽

Family History ◽

Mutation Status ◽

Replication Errors ◽

Cancer Group ◽

Amsterdam Criteria ◽

History Of ◽

Regional Population ◽

Colorectal Cancer Patients

Background—Replication errors (RERs) characterise tumours of hereditary non-polyposis colorectal cancer (HNPCC). RER status may therefore improve identification of such families previously diagnosed by family history alone.Aims—To assess RER and HNPCC frequency within a population of colorectal cancer patients and a regional population of family history defined (Amsterdam criteria) HNPCC families.Methods—Family history was assessed by personal interview in a population of 479 patients with colorectal cancer attending one follow up clinic. Seven fluorescently labelled microsatellites were used to investigate RER frequency in colorectal cancers from 89 patients of this population with varying degrees of family history and 20 Amsterdam criteria positive families (four with a known germline mutation, 16 with unknown mutation status) from the regional population.Results—Only four of the follow up population (0.8%) came from families meeting the Amsterdam criteria with only one showing RERs. The frequency of RERs was similar in the early onset cancer group (less than 50 years of age), those with a family history, and those with no family history of colorectal cancer. From the regional population, RERs were identified in 4/4 families with a mutation but only 8/16 families with unknown mutation status.Conclusions—No correlation was seen between RER status and strength of family history except in HNPCC families. Results also indicate that half of the Amsterdam criteria defined families do not exhibit RERs, perhaps suggesting a different mechanism of tumorigenesis.

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