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

The DANCE study evaluated how well family history and age-based criteria identify patients with colorectal cancer. The analysis included 1,158 colorectal cancer cases and 1,434 cancer-free controls from the Detroit area. Results showed that family history varied by age at diagnosis and race: in the African American population, family history of CRC was most common in patients diagnosed before age 45 (22.6%), while in the White population it occurred more frequently with older age. Having a first-degree relative with CRC was associated with higher risk of CRC before age 45 only in the African American population. However, current family history-based criteria identify fewer than half of patients diagnosed before age 45, with performance varying substantially by race. The study emphasizes the need for more equitable and effective approaches to early-onset colorectal cancer risk stratification.