Anxieties should not be forgotten when screening relatives of colorectal cancer patients by colonoscopy

Abstract

Individuals with a strong family history have a high risk of developing colorectal cancer. They could well benefit from targeted screening and their increased risk warrants an invasive procedure such as colonoscopy. This study aims to assess the anxieties of symptom-free relatives offered screening by colonoscopy. A simple questionnaire was sent to 50 consecutive people who had colorectal cancer screening by colonoscopy because of a strong family history. Forty-five questionnaires were answered. On assessing their anxiety levels before and after colonoscopy, 56% noticed an improvement after the test, 33% were still as anxious and 11% had raised anxiety levels despite screening. Although most of the screening colonoscopies were normal, 44% of asymptomatic relatives undergoing invasive screening had no improvement of their cancer anxieties. Screening people with a strong family history of colorectal cancer may be an efficient, cost-effective and focussed way of detecting early neoplasms rather than screening the general population. Using colonoscopy alone however, a large proportion of people still have cancer anxieties after being screened. This small study suggests that in order to attempt to alleviate anxieties, a colonoscopy alone is insufficient for some in this high-risk group.