title: Determinants of participation in colonoscopic screening by siblings of colorectal cancer patients in France.
abstract: BACKGROUND
  Targeted colonosocopic screening is recommended for first-degree relatives of colorectal cancer patients diagnosed before the age of 60 and offers the possibility of reducing morbidity and mortality, but participation remains too low. The objective of this study was to determine in a French population the factors that affect siblings' participation in screening, notably those relating to the individuals, their medical care, their family and their social network.
  
  
  METHODS
  A cross sectional survey was conducted in siblings of index patients having undergone surgery for colorectal cancer between 1999 and 2002 in two French counties. Siblings were contacted during 2007 and 2008 through the index patient. The factors affecting participation in colonoscopic screening were studied by logistic regression taking into account family cluster effect.
  
  
  RESULTS
  172 siblings of 74 index cases were included. The declared rate of undergoing at least one colonoscopy among siblings was 66%; 95%CI 59-73%. Five variables were independently associated with colonoscopic screening: perceiving fewer barriers to screening (OR = 3.2; 95%CI 1.2-8.5), having received the recommendation to undergo screening from a physician (OR = 4.9; 1.7-13.7), perceiving centres practising colonoscopy as more accessible (OR = 3.2, 1.3-7.8), having discussed screening with all siblings (OR = 3.9; 1.6-9.6) and being a member of an association (OR = 2.6; 1.0-6.6).
  
  
  CONCLUSIONS
  The factors independently associated with participation in CRC screening by an individual at increased risk belonged to each of four dimensions relating to his individual psychosocial characteristics, to his relationship with a physician, within the family and social environment. The relevance of these results to clinical practice may help to improve compliance to recommendations in a global preventive strategy including all stages of the information pathway from the physician to the index patient and his relatives.
authors.affiliation: Public Health, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, 86005 Poitiers Cedex, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Taouqi
authors.forename: Isabelle
authors.initials: I
authors.lastname: Ingrand
authors.forename: Michel
authors.initials: M
authors.lastname: Beauchant
authors.forename: Virginie
authors.initials: V
authors.lastname: Migeot
authors.forename: Pierre
authors.initials: P
authors.lastname: Ingrand
mesh_terms: D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D011379:Prognosis; D012189:Retrospective Studies; D035781:Siblings; D015996:Survival Rate