Single-visit screening and treatment of first-degree relatives. Colon cancer pilot study

A pilot study has been carried out to evaluate three aspects of screening of first-degree relatives of patients with colon cancer in four Hamilton hospitals; yield of adenomas, feasibility of a one-visit approach to screening and treatment, and compliance. Protocol included flexible sigmoidoscopy after full bowel preparation, followed immediately by either therapeutic colonoscopy or diagnostic barium enema, depending on the flexible sigmoidoscopy findings. We found adenomas in 19 percent of 88 first-degree relatives, with a mean age of 52, compared with an expectation of 8 percent. The protocol was found to be acceptable to the relatives and workable for the various groups of physicians in three of four hospitals, despite many initial logistic difficulties. Numerous problems were encountered with compliance of referring physicians, index patients, relatives, and investigating physicians.