Colorectal Cancer Personalized Screening Program

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Screening tests for CRC can improve disease prognosis by identifying early-stage CRC that is easier to treat and has a lower mortality rate than CRC detected after symptoms develop. Screening can also prevent CRC by detecting and removing premalignant polyps before they progress to CRC.

Studies indicate that colonoscopy, sigmoidoscopy, and both guaiac-based fecal occult blood testing (gFOBT) and fecal immunochemical tests are each associated with a decreased risk of CRC mortality. The effectiveness of multitargeted stool DNA testing is inferred because of better sensitivity for advanced adenomas and early CRC compared with occult blood testing. Abnormal results of initial noninvasive screening tests other than colonoscopy necessitate a colonoscopy to evaluate the abnormality.

Initiating screening at age 50 years for average-risk adults is recommended by most professional society guidelines and expert groups, including the US Preventive Services Task Force, the Canadian Task Force on Preventive Health Care, the European Council, the American Academy of Family Physicians, and the American College of Physicians. Screening at least until age 75 years for patients at average risk for CRC is recommended by most guidelines.

Specifying the level of a person’s risk of illness helps to plan prevention and screening more effectively. One way to do this is to consider inherited risk. Studies have shown that polygenic risk scores may lead to recommendations for personalized screening, using the fecal occult blood test and colonoscopy, for high-risk individuals in age groups significantly younger than current recommendations do. For those purposes, we have developed and implemented the test based on the polygenic risk score – AnteCRC. The use of the AnteCRC test is to reduce the risk of premature mortality due to CRC by the implementation of primary and secondary prevention measures.

AnteCRC data show that 15% of people have an increase in the risk of developing CRC of over 1.5 times and 5% more than twice. Some people are already at higher risk as early as ten years before the age of the same risk in the current screening group. Based on this information, it is possible to make more specific recommendations for the prevention and screening of CRC.

Given the calculated polygenic risk level of AnteCRC, we recommend:

Apply CRC screening at the age when the risk of developing the disease reaches the average risk level of people 50 years of age.

For the methods we recommend:

  1. Colonoscopy every ten years if the patient wishes to undergo this procedure.
  2. Immunochemical test for fecal occult blood once a year if the patient does not want a colonoscopy.
  3. If the risk is greater than two times, we recommend colonoscopy from the age of 50.

Screening for colon cancer helps to find pre-cancerous conditions as well as early-stage tumors without symptoms. In addition to the effect of polygenic risk SNPs, other risk factors influence the development of CRC cancer.

The program can be used in ordering the AnteCRC test. The program is suitable for women and men in age 40 – 75.