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Z Gastroenterol 2018; 56(04): 361-364
DOI: 10.1055/s-0043-123882
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Screening interval recommendations following a normal colonoscopy in individuals with a familial risk of colorectal cancer

Empfehlungen zum Screening-Intervall nach unauffälliger Koloskopie bei Personen mit familiärem Risiko für Darmkrebs
Jasper Plath
1   Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
2   German Cancer Research Center (DKFZ), Heidelberg, Germany
3   German Cancer Consortium (DKTK), Frankfurt, Germany
,
Andrea Siebenhofer
1   Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
4   Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
,
Corina Guethlin
1   Institute of General Practice, Goethe University Frankfurt, Frankfurt, Germany
,
Irina Blumenstein
5   University Clinic Frankfurt, Department of Gastroenterology, Frankfurt, Germany
› Author Affiliations
Further Information

Publication History

27 July 2017

22 November 2017

Publication Date:
16 January 2018 (online)

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Abstract

Background In view of the increased risk of developing colorectal cancer (CRC) in individuals with affected first-degree relatives (FDRs), the German evidence-based S3 guideline recommends having the first screening colonoscopy early and then, following a normal examination, repeating it at least every 10 years. The aim of this analysis was to explore colonoscopy interval recommendations in clinical practice among individuals aged < 55 years with a familial risk of CRC.

Methods We analyzed data from the FRIDA.Frankfurt study. Patients aged 40 – 54 years with at least 1 reported FDR with CRC (excluding suspected/known hereditary cancer syndromes) and a normal colonoscopy result (no findings) were included. Data on colonoscopist recommendations for intervals between subsequent colonoscopies were extracted from colonoscopy reports.

Results Of 63 reports of normal colonoscopies, 20 (32 %) did not include a recommendation on when to undergo a further colonoscopy. Of 43 reports with recommendations, 40 (93 %) suggested an interval that was shorter than the recommended maximum interval in the guideline: 1 (2 %) was for a 3-year interval, 37 (86 %) were for 5-year intervals, and 2 (5 %) were for 8-year intervals.

Conclusions Although the low number of cases limits generalizability, the results indicate that recommended intervals in clinical practice are considerably shorter than the recommended maximum interval in the guideline.

Zusammenfassung

Hintergrund Unter Berücksichtigung des erhöhten Risikos für kolorektale Karzinome (KRK) bei Personen mit von einem KRK betroffenen Angehörigen ersten Grades wird in der deutschen S-3 Leitlinie eine frühe Durchführung der ersten Koloskopie und bei unauffälligem Befund eine Kontrolle mindestens alle 10 Jahre empfohlen. Ziel dieser Untersuchung war die Analyse von Empfehlungen aus der klinischen Praxis zum Intervall der Früherkennungskoloskopie, die für Personen unter 55 Jahren mit familiärem Risiko ausgesprochen wurden.

Methode Analyse von Daten der Studie FRIDA.Frankfurt: Personen im Alter von 40 bis 54 Jahren mit mindestens einem Angehörigen ersten Grades mit KRK und unauffälliger Koloskopie wurden eingeschlossen. Personen mit Verdacht auf oder bekanntem hereditären Syndrom wurden ausgeschlossen. Angaben zu empfohlenen Intervallen zur nächsten Koloskopie wurden aus Koloskopieberichten extrahiert.

Ergebnisse Von 63 Berichten zu unauffälligen Koloskopien enthielten 20 (32 %) keine Empfehlung zum Zeitpunkt der nächsten Koloskopie. Von 43 Berichten mit Empfehlung enthielten 40 (93 %) eine Empfehlung für ein kürzeres Intervall als das in der Leitlinie genannte maximale Intervall: Ein Bericht (2 %) enthielt die Empfehlung 3 Jahre, 37 (86 %) die Empfehlung 5 Jahre und 2 (5 %) die Empfehlung 8 Jahre bis zur nächsten Koloskopie.

Schlussfolgerung Obwohl die geringe Zahl der Fälle die Generalisierbarkeit limitiert, weisen die Ergebnisse darauf hin, dass die empfohlenen Intervalle in der Praxis deutlich kürzer sind als das empfohlene maximale Intervall der Leitlinie.

Key words

colorectal neoplasms - familial risk - colonoscopy - surveillance - screening

Schlüsselwörter

Kolorektales Karzinom - familiäres Risiko - Koloskopie - Kontrolle - Screening
 

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