Report in English with a Dutch summary (KCE reports 45A)

172 Screening for Colorectal Cancer: Appendices KCE reports vol.45
4 Guidelines for the
Prevention, Early
Detection and
Management of
Colorectal Cancer 50
5 American Cancer
Society guidelines on
screening and
surveillance for the
early detection of
adenomatous polyps
and colorectal cancer
- update 200456 .
6 Surveillance and
management of
groups at increased
risk of colorectal
cancer27 .
Australian Cancer Network
Colorectal Cancer
Guidelines Revision
Committee
American Cancer Society
(ACS)
New Zealand Guidelines
Group (NZGG)
2005 1 FDR with CRC diagnosed at 55 years
or over (included in category 1 RR up to
2-fold)
1 FDR with CRC diagnosed under 55
years (RR 3 to 6-fold)
2 FDR with CRC diagnosed at any age
(RR 3 to 6-fold)
2004 Either CRC or adenomatous polyps in any
FDR < 60 y, or in 2 FDR at any age (if
not a hereditary syndrome).
CRC in relatives more distant than FDR
does not increase risk substantially above
the average risk group
2004 Category 3 risk:
1 FDR plus 2 FDR or SDR, all on the
same side of the family, with a diagnosis or
CRC at any age
2 FDR, or 1 FDR plus 1 SDR, all on
the same side of the family, with a
diagnosis of CRC and one such relative (1)
was diagnosed with CRC under age of 55
y, (2) developed multiple bowel cancers,
or (3) developed an extra-colonic tumor
suggestive of hereditary nonpolyposis
colorectal cancer (i.e., endometrial,
ovarian, stomach, small bowel, upper renal
tract, pancreas, or brain)
At least 1 FDR or SDR diagnosed with
CRC in association with multiple bowel
polyps
1 FDR with CRC diagnosed < 50 y,
particularly if colorectal tumor
immunohistochemistry has revealed loss
of protein expression for one of the
mismatch repair genes (hMLH1 or
hMSH2)
Colonoscopy
FS and DCBE or CT
colonography may be
offered if colonoscopy is
contraindicated for some
reason.
50 y. or 10 years
younger than the
age of first
diagnosis of
bowel cancer in
the family,
whichever
comes first.
Colonoscopy Age 40, or 10 y
before the
youngest case in
the immediate
family
Suspect hereditary
disease and refer patient
to:
A genetic
specialist/family cancer
clinic or familial bowel
cancer registry for
further risk assessment
and possible genetic
testing
If yes see
surveillance; if no
colonoscopy
40 y or 10 y
younger than
affected relative
(whichever is
younger),
Repeat every 5
y.
Every 5-10 y Evidence
discussed
but not
explicitly
rated
Repeat every 1-5
y
III-2 Recommended
Grade 5
N/A
See Appendix 2
NZGG National
Health Committee
evidence grading
hierarchy