domingo, 19 de febrero de 2017

Family History in Colonoscopy Patients: Feasibility and Performance of Electronic and Paper-based Surveys for Colorectal Cancer Risk Assessment in ... - PubMed - NCBI

2017 Feb 4. pii: S0016-5107(17)30080-9. doi: 10.1016/j.gie.2017.01.036. [Epub ahead of print]

Family History in Colonoscopy Patients: Feasibility and Performance of Electronic and Paper-based Surveys for Colorectal Cancer Risk Assessment in the Outpatient Setting.

Guivatchian T1, Koeppe ES2, Baker JR2, Moisa C3, Demerath M3, Foor-Pessin C4, Chey WD2, Eswaran SL2, Kolars JC2, Menees SB2, Rajala M5, Rice MD2, Rizk R2, Rubenstein JH2, Sharma P2, Todisco A2, Stoffel EM2.

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Abstract

BACKGROUND AND AIMS:

Family history is crucial in stratifying patients' risk for colorectal cancer (CRC). Previous risk assessment tools developed for use in clinic or endoscopy settings have demonstrated suboptimal specificity for identifying patients with hereditary cancer syndromes. Our aim was to test the feasibility and performance of 2 family history surveys (paper and electronic) in individuals presenting for outpatient colonoscopy.

METHODS:

Patients presenting for outpatient colonoscopy at a tertiary care center were asked to complete a 5 question paper risk assessment survey (short paper survey) either alone or in conjunction with a second, comprehensive electronic family risk assessment survey (comprehensive tablet survey). Each subject's survey results, along with the electronic medical record, were reviewed and 10 high-risk criteria and PREMM1,2,6 model scores were used to identify patients warranting genetic evaluation for suspected hereditary cancer syndromes.

RESULTS:

600 patients completed the short paper survey (cohort 1), with an additional 100 patients completing both the short paper and comprehensive tablet survey (cohort 2). Using 10 high-risk criteria and/or a PREMM1,2,6 score ≥ 5%, we identified 10% and 9% of patients as high risk for CRC in cohorts 1 and 2, respectively. Of the 69 high-risk subjects, 23 (33%) underwent genetic evaluations, and 7 (10%) carried germline mutations associated with cancer predisposition. Both patients and endoscopists reported the tools were user-friendly and helpful CRC for risk stratification.

CONCLUSIONS:

Systematic assessment of family history in colonoscopy patients is feasible and can help endoscopists identify high-risk patients who would benefit from genetic evaluation.