Embargoed for Release Until: Sunday, October 11, 1998, 6:00 p.m. Contact: Dana Victor Montenegro 202/973-5871 or [email protected]
Positive Family History of Colon Cancer Should Guide Screening Decisions Among Ashkenazi Jews
Boston, MA, October 11, 1998 -- With the identification of a genetic mutation associated with colon cancer in Ashkenazi Jews, positive family history of colorectal cancer is a strong indication for early and aggressive screening. A study at the Cleveland Clinic Foundation found that Jewish individuals of Eastern European descent (Ashkenazi Jews) with a family history of colon cancer who themselves develop colon cancer are younger at the time of diagnosis and are more likely to have cancers located in the proximal colon, or right side of the colon. The study was released at the 63rd Annual Scientific Meeting of the American College of Gastroenterology (ACG).
According to the Cleveland Clinic researchers, "more aggressive screening may therefore be indicated in Ashkenazi Jews with a positive family history of colorectal cancer, but not in those with a negative family history." Data from the National Cancer Institute indicate that genetic mutation has been detected in six percent of Ashkenazi Jews and appears in 28 percent of Ashkenazi Jews with colorectal cancer. The Cleveland Clinic researchers reviewed records of 115 Jews with colorectal cancer (researchers report that Ashkenazi Jews comprise over 90% of the total Jewish population in Cleveland) to assess whether age at diagnosis, tumor location or stage of colorectal cancer differs from the general population.
Of those studied, 47 were women and 68 were men and the mean age of diagnosis for colorectal cancer was 66 years. Family history was unknown for 36 percent of subjects. Ashkenazi Jews with a positive family history of colorectal cancer were younger when their cancers were detected, with mean age at diagnosis of 60 years compared to 65 years for those without a family history and 67 for the general population. Ashkenazi Jews with a positive family history also had a greater incidence of cancers located in the proximal colon, which can only be identified with colonoscopy, a examination of the entire colon.
Most colon cancers arise from polyps, growths on the wall of the colon that can become cancerous over time. If polyps are identified at an early stage, frequently they can be removed before they become cancerous. For normal risk individuals, without a genetic predisposition or other risk factor, screening tests should begin at age 50 and consist of annual stool test for blood, and a flexible sigmoidoscopic exam every 5 years to detect colorectal cancer at its earliest and most treatable stage. In recent years, colonoscopy every 7 to 10 years for average risk patients has gained increasing acceptance as another screening alternative. Colonoscopy is recommended for individuals of any age who are at higher than average risk for developing colorectal cancer by virtue of prior history of colorectal cancer or colon polyps, a strong family history of the disease, or predisposing chronic digestive condition such as inflammatory bowel disease. Frequency of colonoscopy varies for ! different subsets of high risk patients, and they should consult with their physician.
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