Screening patients with a family history of colorectal cancer.
OBJECTIVE
To compare screening practices and beliefs in patients with and without a clinically important family history.


METHODS
We mailed a brief questionnaire asking about family history and a second, longer survey asking about knowledge of and beliefs about colorectal cancer to all respondents with a family history and a random sample of respondents without a family history of colorectal cancer. We reviewed electronic medical records for screening examinations and recording of family history.


METHODS
One thousand eight hundred seventy of 6,807 randomly selected patients ages 35-55 years who had been continuously enrolled in a large multispecialty group practice for at least 5 years.


METHODS
Recognition of increased risk, screening practices, and beliefs-all according to strength of family history and patient's age.


RESULTS
Nineteen percent of respondents reported a family history of colorectal cancer. In 11%, this history was strong enough to warrant screening before age 50 years. However, only 39% (95% CI 36, 42) of respondents under the age of 50 years said they had been asked about family history and only 45% of those with a strong family history of colorectal cancer had been screened appropriately. Forty-six percent of patients with a strong family history did not know that they should be screened at a younger age than average risk people. Medical records mentioned family history of colorectal cancer in 59% of patients reporting a family history.


CONCLUSIONS
More efforts are needed to translate information about family history of colorectal cancer into the care of patients.
Fletcher
Robert H
RH
Department of Ambulatory Care and Prevention, Harvard Medical School, Harvard Pilgrim Health Care, and Harvard Vanguard Medical Associates, Boston, MA, USA. Robert_Fletcher@hms.harvard.edu
Lobb
Rebecca
R
Bauer
Mark R
MR
Kemp
James Alan
JA
Palmer
Richard C
RC
Kleinman
Ken P
KP
Miroshnik
Irina
I
Emmons
Karen M
KM
D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged