What is the relative risk of colorectal cancer in patients with a positive family history?

Although colorectal cancers are sporadic, a family history is clearly recognized as being a strong risk factor. In order to assess the impact of having a first degree relative (FDR) with colorectal cancer (CRC), Wong and colleagues evaluated 63 studies in which 9.28 million individuals had been reported. Perhaps not surprisingly the authors confirmed that a family history of CRC in FDR confers a globally higher risk. However, perhaps not intuitively they found that this risk was highest in younger patients and lowest in older patients. Accordingly they suggest that the family history of CRC in FDR should be weighted differently in younger as compared to older subjects. This finding helps us understand the importance of colonoscopy particularly in younger patients particularly in younger patients who have an FDR who had CRC.