Familial colorectal cancer

Familial colorectal cancer fact sheet

Clinical features

Individuals with familial colorectal cancer (CRC) are at an increased risk to develop colorectal
cancers over the general population risk. Familial CRC is more common than the rarely
inherited CRC syndromes [e.g., Lynch syndrome, familial adenomatous polyposis (FAP)], and
accounts for approximately 25 percent of CRC diagnoses. Factors such as number of relatives
and age of onset of CRC affect the risk for CRC in the unaffected patient.

Diagnosis of familial CRC

Familial CRC is characterized by having one first-degree relative diagnosed with CRC or colon
polyps before the age of 60, or two first-degree relatives diagnosed with CRC or colon polyps at
any age.

Inheritance

Familial CRC follows a multifactorial inheritance pattern in which a combination of genes and
environmental factors influence the risk to develop cancer.

Genetics

Familial CRC is believed to be caused by a combination of genetic and environmental factors.

A grouping of low-penetrance susceptibility genes may increase ones risk to develop CRC.
Because the genetic susceptibility factors have not yet been identified, no diagnostic genetic
testing is available.

Color cancer risk

General First-degree First-degree Two first-degree
population relative with CRC relative with relatives with
diagnosed after CRC diagnosed CRC
50 years before 45 years
Male 5.6% 23 fold increase 36 fold increase 36 fold increase
Female 5.3% 23 fold increase 36 fold increase 36 fold increase

Colorectal Cancer Fact Sheets: Familial colorectal cancer | 1

 Familial colorectal cancer

Screening recommendations

Management is based on adjusting lifestyle factors associated with CRC (e.g., diet, alcohol use,
exercise) and initiating early and more frequent screening based on the individuals specific
family history.

Family history Screening recommendation

One first-degree relative with Colonoscopy every 35 years,
CRC diagnosed < 50 years depending on rest of family history,
beginning at age 40 or at an age
or 10 years younger than the earliest
case of CRC in the family
Two first-degree relatives with
CRC at any age

One first-degree relative with CRC Colonoscopy every 5 years,

diagnosed 5060 years beginning at age 40
One first-degree relative with CRC Colonoscopy every 5 years,
diagnosed > 60 years beginning at age 50 years

or

Two related second-degree relatives with

CRC at any age

One second- or any third-degree relatives Average risk screening

with CRC

References:
Jasperson, KW, et al. (2010) Hereditary and familial colon cancer. Gastroenterology, 138:6

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Colorectal Cancer Screening. Version 2.2011.
www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed 28 February 2012.

11-0456:2/12:jt:Updated Feb 2012 Colorectal Cancer Fact Sheets: Familial colorectal cancer | 2