Abstract

BackgroundThe aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines.MethodsColorectal cancer patients and their FDRs were recruited through the population-based Victorian Cancer Registry, Victoria, Australia. Seven hundred and seven FDRs completed telephone interviews. Of these, 405 FDRs were deemed asymptomatic and eligible for analysis.ResultsSixty-nine percent of FDRs had ever received any CRC testing. First-degree relatives of older age, those with private health insurance, siblings and FDRs who had ever been asked about family history of CRC by a doctor were significantly more likely than their counterparts to have ever received CRC testing. Twenty-five percent of FDRs “at or slightly above average risk” were adherent to CRC screening guidelines. For this group, adherence to guideline-recommended screening was significantly more likely to occur for male FDRs and those with a higher level of education. For persons at “moderately increased risk” and “potentially high risk”, 47% and 49% respectively adhered to CRC screening guidelines. For this group, guideline-recommended screening was significantly more likely to occur for FDRs who were living in metropolitan areas, siblings, those married or partnered and those ever asked about family history of CRC.ConclusionsA significant level of non-compliance with screening guidelines was evident among FDRs. Improved CRC screening in accordance with guidelines and effective systematic interventions to increase screening rates among population groups experiencing inequality are needed.Trial RegistrationAustralian and New Zealand Clinical Trial Registry: ACTRN12609000628246

Highlights

  • The aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines

  • The aim of this study was to examine among FDRs of persons diagnosed with CRC and at each level of risk (“at or slightly above average risk”, “moderately increased risk” and “potentially high risk”), the proportions (i) ever receiving any CRC testing in their lifetime and (ii) screened in accordance with Australian CRC screening guidelines

  • Setting and design Index cases and their FDRs were recruited through the population-based Victorian Cancer Registry (VCR), Victoria, Australia between 2009 and 2011

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Summary

Introduction

The aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines. The relative risk of developing CRC is further increased where a known genetic mutation has been identified [15]. Screening guidelines for persons at higher risk generally recommend additional types of testing (e.g. colonoscopy rather than, or in addition to, FOBT), more frequent testing and commencement of testing at an earlier age, compared with their average risk counterparts [18,19,20]. For persons at “moderately increased risk”, colonoscopy is endorsed every five years starting at age 50 years or at ten years earlier than first diagnosis in the family, whichever comes first [18]. Age at screening commencement, test type and repeat testing interval are dependent on the type of family-specific mutation identified [18]

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