title: Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer.
abstract: BACKGROUND
  Colonoscopy is one of the methods of choice for screening relatives of patients with colorectal cancer.
  
  
  OBJECTIVE
  To evaluate the rate of adherence to colonoscopy in first-degree relatives of patients with colorectal cancer and describe the lesions found.
  
  
  METHODS
  A prospective, cross-sectional, multicentre, nationwide study was conducted. The study population was composed of first-degree relatives of patients with colorectal cancer selected randomly from the EPICOLON study. Seventy-four index patients were included. These had 342 living first-degree relatives (parents, siblings and children), of whom 281 were interviewed.
  
  
  RESULTS
  The adherence rate was 38% (107/281). Adherence was greater in families with a higher degree of familial aggregation for colorectal cancer (88.9% for Amsterdam vs 33.3% for Bethesda and sporadic cancer; p<0.05), an index patient aged under 65 years (60% for patients <65 years vs 32.9% for patients >or=65 years; p<0.05) and an index patient who was female (46.2% for women vs 31% for men; p = 0.28). Adherence was also greater in relatives under 65 years (54% in patients <65 years vs 18% in patients >or=65 years; p = 0.05), in female relatives (49% in female relatives vs 27.3% in male relatives; p<0.05) and in siblings and children (40% in siblings and children vs 13% in parents; p<0.05). Lesions were found in 26% (28/107) of the study population. Nine (8.4%) individuals had a total of 18 advanced lesions.
  
  
  CONCLUSIONS
  These results indicate that adherence to colonoscopy in our population of first-degree relatives was low. The adherence was more frequently associated with a higher degree of familial aggregation, a relative age of under 65 years, a sibling or offspring relationship, and female sex.
authors.affiliation: Department of Gastroenterology, Donostia Hospital, San Sebastian, Spain. medik@telefonica.net
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarasqueta
authors.forename: Leire
authors.initials: L
authors.lastname: Zubiaurre
authors.forename: Angel
authors.initials: A
authors.lastname: Cosme
authors.forename: Carmen
authors.initials: C
authors.lastname: Muñoz
authors.forename: Araceli
authors.initials: A
authors.lastname: Sánchez
authors.forename: Cristina
authors.initials: C
authors.lastname: Martín
authors.forename: Llucia
authors.initials: L
authors.lastname: Tito
authors.forename: Virginia
authors.initials: V
authors.lastname: Piñol
authors.forename: Antoni
authors.initials: A
authors.lastname: Castells
authors.forename: Xavier
authors.initials: X
authors.lastname: Llor
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Xicola
authors.forename: Elisenda
authors.initials: E
authors.lastname: Pons
authors.forename: Juan
authors.initials: J
authors.lastname: Clofent
authors.forename: María L
authors.initials: ML
authors.lastname: de Castro
authors.forename: Jaime
authors.initials: J
authors.lastname: Cuquerella
authors.forename: Enrique
authors.initials: E
authors.lastname: Medina
authors.forename: Ana
authors.initials: A
authors.lastname: Gutierrez
authors.forename: Juan I
authors.initials: JI
authors.lastname: Arenas
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jover
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003113:Colonoscopy / Q000523:psychology* / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain