Colorectal cancer screening in first-degree relatives of colorectal cancer: participation, knowledge, and barriers against screening

Background Family history is one of the most important risk factors for developing colorectal cancer (CRC), and medical organizations recommend CRC screening in this population. However, the use of CRC screening is still low in our country. Objective To investigate the use of CRC screening, knowledge about CRC and screening tests, and factors related to screening in a family-risk population. Methods A total of 334 family-risk participants answered a questionnaire to assess the use of CRC screening tests, knowledge about CRC, risk perception, and barriers against screening. Results In total, 22% of participants had undergone at least one of the recommended tests for CRC screening. Furthermore, indication for screening was found in only 8% of participants. Use of CRC screening tests was significantly lower than mammography for breast cancer detection in women (20 vs. 82%, P<0.001) and use of serum prostate-specific antigen for prostate cancer detection in men (27 vs. 46%, P<0.001). Most participants (59%) knew that being elderly was a risk factor and only about half (47%) had knowledge about any of the recommended examinations. Only in about half of the cases (47%) was subjective risk perception higher than in the general population. In the logistic regression analysis, having more than one affected relative (odds ratio = 2.63, 95% confidence interval: 1.05-6.68; P = 0.03) and a high subjective perception of risk (odds ratio = 2.87, 95% confidence interval: 1.10-7.46; P=0.03) were independent predictors for CRC screening. Conclusion Less than 25% of the family-risk population has undergone a CRC screening test. Family history and subjective risk perception of CRC are the strongest predictors of CRC screening. Eur J Gastroenterol Hepatol 23: 1165-1171 (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.