Although early detection strategies are limited for these cancers, some experts recommend the use of screening measures such as serum CA-125 levels, pelvic ultrasound and urine cytology when these cancers are present in the family. Family history evaluation is thus a two-step process. In the first step, the presence or absence of a family history of colorectal cancer is determined. If a positive history of CRC is found, the second step determines whether the family history indicates a possible high-risk family. An example of this approach to family history is outlined in the table here.
Some families fall into an intermediate category of risk.
For example, a family may include two affected relatives, neither of whom was affected before age 50 or a single affected relative affected before age 40. In some cases, additional cancers may occur and confirm the family as high-risk. In other cases, the family remains in an intermediate category. A common approach to screening in such families is to initiate colorectal cancer screening ten years earlier than the age of diagnosis of the youngest affected family member. In addition, a personal or family history of colorectal cancer has been shown in epidemiological studies to be associated with a small increased risk for other common cancers such as breast cancer.