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Family History and Colon Cancer Risk

Watch this video from the Colon Cancer Alliance, in which Dr. Durado Brooks, Director of the American Cancer Society's Prostate and Colorectal Cancer division, explains who is at risk for colorectal cancer and what you can do to prevent or find it early.


I’m Durado Brooks and I’m the Director of Prostate and Colorectal cancers for the American Cancer Society. I am an internist by background, and training and practice for about 15 years and now work full time for the Cancer Society trying to help people and doctors learn about preventing cancer or finding it early.

What role does my family heath history play?

Family history is a very important factor in the risk for developing colon cancer. People who have a single family member who’s diagnosed with colon cancer particularly at a young age, anywhere under the age of 50. Those people have as many as four times the risk of developing colorectal cancer as someone who has no family history or other known risk factors. Even having family members who only have adenomatous polyps, who haven’t had cancer but just have had polyps found can increase your risk by as much as 2 or 3 fold. So it’s very important for people who have polyps or colon cancer to talk with their family. And it’s very important for family members to begin exploring their family history. This is something that a lot of people don’t talk about. They haven’t shared, particularly when you start looking over a couple of generations.

Are there other risk factors?

There are some groups in particular, people who have inflammatory bowel disease, that is Crohn’s disease, or ulcerative colitis. If you have that for 8 to ten years then your risk of developing colon cancer begins to go up very significantly. And again those are people who need to start screening at an earlier age and probably need to be screened more often. Then there are other groups that have increased risk and we’re not really exactly clear why. And as of right now screening recommendations for them are pretty much the same as for the general population. And that’s racial and ethnic groups, for instance, African Americans are at higher risk of developing colorectal cancer and dying from it some Native American populations, and Alaska native populations, people of Ashkenazi Jewish descent also have a higher risk. People need to therefore be aware of this higher risk. And they need to make sure that they begin screening no later than the age of 50. And in addition if they are having some kind of symptoms even in their 30’s, they need to see a doctor and have not screening tests but diagnostic tests. Don’t ignore symptoms at earlier ages because they are at increased risk of developing the disease.

When should I start screening for colon cancer?

To talk a little about colorectal cancer screening guidelines. In general, most groups including the American Cancer Society recommend that if you don’t have any known risk factors for colon cancer you should start screening at age 50 and then how often you’re screened will depend on which test. There are a number of different tests that can be used to screen for colon cancer. Things like stool tests where you collect stool specimens, x-ray studies and also scope exams, that’s colonoscopy in particular. However if you are known to be at increased risk of developing colorectal cancer because of your family history you may need to start screening at much earlier age. As a matter of fact people who have certain genetic syndromes something called FAP or familial adenomatous polyposis may need to start screening as early as age 10 certainly somewhere within in their teens. People who have another genetic syndrome, Lynch syndrome, HNPCC, it’s known by a number of different names but people who have this syndrome in general may need to start screening somewhere in their 20s possibly earlier. And then for individuals who simply have a family history of colon cancer without any of these known genetic syndromes you need to start getting screened about 10 years before the age of your family member who was diagnosed. So if your Mom or Dad was diagnosed at age 50 you need to start screening at age 40. If they were diagnosed at 45 you need to start screening at 35. In addition while there are a number of different tests that are used for people who have no known risk factors for people who are known to be at increased or high risk colonoscopy is the recommended test.