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Colorectal Cancer Screening Among First-Degree Relatives of Colorectal Cancer Patients: Benefits and Barriers

  • Healthcare Policy and Outcomes
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Individuals with a first-degree family history of colorectal cancer (CRC) are at increased risk of CRC. Study objectives were: (1) to estimate the proportion of first-degree relatives (FDR) of CRC patients being screened for CRC and (2) to identify predictors of screened behavior.

Methods

A questionnaire was mailed to 640 stage I–III CRC patients from a population-based registry to identify FDR. A survey was sent to 747 FDR, aged 40 or older, to assess CRC screening, knowledge, demographics, access, benefits, and barriers of CRC screening. Factor analysis was used to detect underlying constructs. Predictors of screening were explored by multivariate analysis (MVA).

Results

There was a 54% and 51% response for patients and FDR, respectively. Among FDR, 86% were born in Canada, 94% spoke English, 93.5% had a high school education, 73% were married, and 55% were employed. The age distribution was: 40–44 years (19.7%), 45–49 (19.1%), 50–54 (16%), 55–59 (15.2%), 60–64 (9.8%), and >65 (18%). Seventy percent had undergone CRC screening with 60% adherent to current guidelines. Of those screened, 33.7% had fecal occult blood testing, 19.4% had barium enema, 10.7% had sigmoidoscopy, and 58.7% had colonoscopy. Five constructs influencing CRC screening include: salience and coherence, perceived susceptibility, response efficacy, social influence, and cancer worries. MVA determined age >50 years as the most important predictor of screening.

Conclusion

In this survey, 70% of FDR of CRC patients had undergone screening; age was the most important predictor. Understanding underlying constructs influencing screening behavior may improve uptake of CRC screening in this population.

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Acknowledgment

The authors would like to acknowledge the helpful discussions regarding study design and analysis with Alberta Cancer Registry Staff as well as Dr. Elizabeth McGregor and Dr. Bejoy Thomas.

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Authors and Affiliations

  1. Department of Surgery and Oncology, University of Calgary, Calgary, AB, Canada

    Lloyd A. Mack MD, MSc, FRCSC & Walley J. Temple MD, FRCSC, FACS

  2. Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA

    Linda S. Cook PhD

  3. Department of Oncology, University of Calgary, Calgary, AB, Canada

    Linda E. Carlson MD, PhD

  4. Department of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada

    Robert J. Hilsden MD, PhD, FRCPC

  5. Department of Surgery, University of Calgary, Calgary, AB, Canada

    Elizabeth Oddone Paolucci PhD

Authors
  1. Lloyd A. Mack MD, MSc, FRCSC
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  2. Linda S. Cook PhD
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  3. Walley J. Temple MD, FRCSC, FACS
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  4. Linda E. Carlson MD, PhD
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  5. Robert J. Hilsden MD, PhD, FRCPC
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  6. Elizabeth Oddone Paolucci PhD
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Correspondence to Lloyd A. Mack MD, MSc, FRCSC.

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Mack, L.A., Cook, L.S., Temple, W.J. et al. Colorectal Cancer Screening Among First-Degree Relatives of Colorectal Cancer Patients: Benefits and Barriers. Ann Surg Oncol 16, 2092–2100 (2009). https://doi.org/10.1245/s10434-009-0528-z

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  • DOI: https://doi.org/10.1245/s10434-009-0528-z

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