An interdisciplinary approach to reducing the incidence of colorectal cancer in NL

Lifetime risk of colorectal cancer (CRC) is 7%. CRC is the most hereditable of the common cancers. It can be prevented by screening colonoscopy. Newfoundland has the highest rate of CRC in Canada and the highest rate of familial CRC in the world. Four percent of incident CRC in NL were caused by mutations in known genes, but a further 8% had a family history consistent with autosomal dominant inheritance of unknown etiology. A further 18% had at least one family member with CRC. The impact of screening colonoscopy in MSH2 carriers was substantial but barriers to successful screening were present in the health care system. A translational project has been started to identify families at risk of CRC in the community.