Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer.
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.
Bujanda
Luis
L
Department of Gastroenterology, Donostia Hospital, San Sebastian, Spain. medik@telefonica.net
Sarasqueta
Cristina
C
Zubiaurre
Leire
L
Cosme
Angel
A
Muñoz
Carmen
C
Sánchez
Araceli
A
Martín
Cristina
C
Tito
Llucia
L
Piñol
Virginia
V
Castells
Antoni
A
Llor
Xavier
X
Xicola
Rosa M
RM
Pons
Elisenda
E
Clofent
Juan
J
de Castro
María L
ML
Cuquerella
Jaime
J
Medina
Enrique
E
Gutierrez
Ana
A
Arenas
Juan I
JI
Jover
Rodrigo
R
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