Colorectal cancer: increased risk for relatives - start screening early

Colon cancer in the family: relatives rarely perceive early detection

It has long been known that people whose direct relatives have colorectal cancer have an increased risk of colorectal cancer themselves. You should therefore start taking preventive measures from the age of 40. However, far too few of them perceive early detection.

Colon cancer is one of the most common cancers in Germany. Around every eighth cancer in this country affects the intestine. Many diseases could be prevented if more people would go to regular checkups. Prevention is particularly important if the family has had colon cancer.

Risk-adjusted early detection

As the German Cancer Research Center (DKFZ) writes in a current communication, people whose direct relatives are suffering from colorectal cancer have an increased risk of colorectal cancer themselves and should therefore start taking preventive measures from the age of 40.

In Germany, this applies to around one in ten people between the ages of 40 and 54. However, almost half of those affected do not take advantage of this opportunity for risk-adjusted early detection, as scientists from the DKFZ report in the specialist journal "Clinical Gastroenterology and Hepatology".

Increased risk of illness with family history

The researchers from the DKFZ wrote to 160,000 people between the ages of 40 and 54 from Stuttgart, Munich and Dresden, 28,711 of those contacted finally took part in the survey on familial colorectal cancer and on participating in colorectal cancer screening.

According to the announcement, 9.4 percent of the respondents, roughly every tenth, stated that one of their direct relatives (parents or children) had colon cancer.

It is known that people with such a family history have an increased risk of developing a malignant tumor of the intestine themselves.

The increased danger also exists for half-siblings, as researchers from the DKFZ and NCT Heidelberg (a joint institution of the DKFZ, the Heidelberg University Hospital (UKHD) and the German Cancer Aid) reported last year together with international colleagues. Their results were published in the specialist magazine "BMJ".

People with colorectal cancer cases in the family are therefore recommended to start colon cancer screening from the age of 40.

For people with no known risk factors, on the other hand, it is now recommended to start preventive medicine at the age of 50.

A large proportion of the people in the current study who were at increased family risk were apparently aware of the importance of starting prevention earlier: over half (54.5 percent) of them had already had a colonoscopy. It was only a quarter of those without family history.

Sensitize those affected for an effective preventive medical check-up

"Viewed from a different perspective, however, this also means that almost half of people with increased family risk do not take advantage of the opportunity to start prevention earlier," says study leader Hermann Brenner from the DKFZ and the National Center for Tumor Diseases (NCT) Heidelberg.

"Here in particular the general practitioners and their employees could make a significant contribution to sensitizing those affected to effective preventive care," says Korbinian Weigl, first author of the current work. "The question of colorectal cancer cases with direct relatives is a very simple and meaningful method to assess the personal risk."

Colon cancer often only occurs at an advanced age

However, the study also showed the limits of this method. Colon cancer often only occurs at an advanced age. If, for example, a colon cancer is diagnosed in an over 70-year-old, his children have often passed the age of 40 for a long time - and thus missed the recommended time for the early detection.

In fact, a breakdown of the data showed that the frequency of sick direct relatives increases with the age of the respondents: 7.5 percent of the 40 to 44 year old study participants had colorectal cancer in the family, among the 50 to 54 year olds already 10.9 percent.

"This makes it clear that people around the age of 40 often do not even know that they belong to the risk group and therefore cannot adhere to the special recommendations for colorectal cancer screening," explains Hermann Brenner.

“And of course, in addition to the family history, many other factors, such as lifestyle habits, play a major role in the risk of colon cancer. Therefore, other methods should also be examined with regard to their suitability for an improved risk assessment, ”said the expert.

Researchers from Brenner's team have recently shown that considering other risk markers together, including various laboratory tests, can be even more meaningful for assessing the risk of personal illness than the question of cancer cases in the family. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • German Cancer Research Center (DKFZ): Colon cancer in the family: Risk-adjusted early detection is perceived too rarely, (accessed: 07.01.2020), German Cancer Research Center (DKFZ)
  • Korbinian Weigl, Kaja Tikk, Michael Hoffmeister, Jochen Hampe, Svitlana Igel, Frank Kolligs, Stefanie J. Klug, Ulrich Mansmann, Oliver Müller, Jutta M. Nagel, Marcus Pichler, Matthias Schwab, Dirk Schweigler, Anna-Magdalena Stephan, Enrico N De Toni, Hermann Brenner: Prevalence of a First-Degree Relative with Colorectal Cancer and Uptake of Screening Among Persons 40 to 54 Years Old Clinical; in: Gastroenterology and Hepatology, (published: November 14, 2019), Clinical Gastroenterology and Hepatology
  • Yu Tian, ​​E. Kharazmi, K. Sundquist, J. Sundquist, H. Brenner, M. Fallah: Familial colorectal cancer risk in half siblings and siblings: nationwide cohort study, in: BMJ, (published: 11.02.2019), BMJ

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