Race and Colorectal Cancer Screening Compliance Among Persons With a Family History of Cancer

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Introduction: The risk of cancer is often higher among families when a family member has a history of cancer. It is unclear whether less than optimal uptake of preventive services contributes to this increased risk of cancer. Aim: To determine adherence to colorectal cancer (CRC) screening guidelines among persons with a family history of any type of cancer and investigate racial differences in screening adherence. Methods: We used the 2007 Health Information National Trends Survey (HINTS) and identified 4,232 respondents (weighted population size = 80,161,151) who were at least 50 years old and did not have a personal history of CRC. We defined being current with CRC screening as the use of fecal occult blood testing (FOBT) within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We compared being up-to-date with CRC screening among those with and without a family member with a history of cancer. We used logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI). Survey weights were used in all analyses and variance estimations were performed using Taylor series linearization to account for the complex survey design. Results: There were 1,094 (27.4%) respondents without a family history of cancer and 3,138 (72.6%) with a family history of cancer. Overall, when compared with respondents without a family history of cancer, those with a family member with cancer were more likely to be current with CRC screening (64.9% versus 55.1%; OR = 1.47; 95%CI: 1.23-1.76) regardless of screening modality. This was due to endoscopy uptake (59.5% versus 49.3%; OR = 1.49; 95%CI: 1.26-1.76) and not with FOBT (15.6% versus 14.6%; OR = 1.13; 95%CI: 0.86-1.49). Blacks had lower screening rates in general and screening rates among blacks with a family history of cancer was not higher than whites without a family history of cancer (Table). Conclusion: Adults with a family history of any cancer were more likely to be screened for CRC. However, increased burden from CRC among blacks may be related to poor uptake of screening among high-risk groups.Table 1: Comparison of being up-to-date with CRC screening by racial distribution of family history of any cancer