Behavioral and economic impact of a familial history of cancers.
BACKGROUND
Misunderstanding of cancer screening recommendations or messages and confidence in the predictive value of positive familial history of disease may converge to stimulate an over-utilization of screening tests in oncology by patients who perceive themselves to be at high risk.


METHODS
A survey looking for predictors of the uptake of five cancer screening tests (mammography, colonoscopy, Fecal Occult Blood Test, upper digestive tract endoscopy and chest X-ray) was carried out on 4000 healthy adults (mean age 46.4 years).


RESULTS
Based on the results of a multivariate analysis, the survey enlightens the existing relationships between familial history and increasing uptake of medical cancer screening tests, with OR ranging from 1.3 (IC 1.0-1.6) for chest X-ray to 3.0 (IC 2.1-4.1) for colonoscopy. In France (60 million inhabitants), a conservative assessment of the annual net number of unhelpful screening tests attributable to positive family history of related cancer with chest X-ray and Upper digestive tract endoscopy lead to a figure of 7000 and 7800 tests respectively corresponding to a total annual cost of more than Euro 7, million.


CONCLUSIONS
Clearer messages about hereditary risks and transparency about the efficacy of screening tests are required in order to decrease over utilization of screening tests and their related costs.
Eisinger
Francois
F
Institute Paoli-Calmettes-INSERM UMR, Marseille, France. eisinger@marseille.inserm.fr
Tarpin
Carole
C
Huiart
Laetitia
L
Horsman
Doug
D
Rabayrol
Laetitia
L
Didelot
Remi
R
Julian-Reynier
Claire
C
Sobol
Hagay
H
D000328:Adult; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000517:prevention & control*