Performance of family history-based colorectal cancer screening criteria by race and age at diagnosis in the Disparities and Cancer Epidemiology (DANCE) study

Performance of family history-based colorectal cancer screening criteria by race and age at diagnosis

This case-control study from the DANCE cohort (1,158 colorectal cancer cases, 1,434 controls) evaluates the performance of family history-based screening criteria by race and age at diagnosis, including NCCN Lynch syndrome testing criteria. Current criteria fail to identify the majority of cases diagnosed before age 45, capturing fewer than one-quarter of non-Hispanic Black cases and fewer than 5% of non-Hispanic White cases. A significant race-by-age interaction was observed. The authors highlight the urgent need for more equitable and effective risk-stratification strategies for early-onset colorectal cancer.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

An important finding: family history criteria, a cornerstone of referral to genetic testing and early screening, miss the vast majority of early-onset colorectal cancers, with added inequity by ancestry. This strengthens the case for strategies less dependent on family history (broader germline testing, or even population screening). Relevant for rethinking referral criteria in digestive cancer genetics.