title: A population-based cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients.
abstract: BACKGROUND
  The aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines.
  
  
  METHODS
  Colorectal cancer patients and their FDRs were recruited through the population-based Victorian Cancer Registry, Victoria, Australia. Seven hundred and seven FDRs completed telephone interviews. Of these, 405 FDRs were deemed asymptomatic and eligible for analysis.
  
  
  RESULTS
  Sixty-nine percent of FDRs had ever received any CRC testing. First-degree relatives of older age, those with private health insurance, siblings and FDRs who had ever been asked about family history of CRC by a doctor were significantly more likely than their counterparts to have ever received CRC testing. Twenty-five percent of FDRs "at or slightly above average risk" were adherent to CRC screening guidelines. For this group, adherence to guideline-recommended screening was significantly more likely to occur for male FDRs and those with a higher level of education. For persons at "moderately increased risk" and "potentially high risk", 47% and 49% respectively adhered to CRC screening guidelines. For this group, guideline-recommended screening was significantly more likely to occur for FDRs who were living in metropolitan areas, siblings, those married or partnered and those ever asked about family history of CRC.
  
  
  CONCLUSIONS
  A significant level of non-compliance with screening guidelines was evident among FDRs. Improved CRC screening in accordance with guidelines and effective systematic interventions to increase screening rates among population groups experiencing inequality are needed.
  
  
  BACKGROUND
  Australian and New Zealand Clinical Trial Registry: ACTRN12609000628246.
authors.affiliation: Priority Research Centre for Health Behaviour, School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, Australia. r.courtney@unsw.edu.au
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Courtney
authors.forename: Christine L
authors.initials: CL
authors.lastname: Paul
authors.forename: Mariko L
authors.initials: ML
authors.lastname: Carey
authors.forename: Robert W
authors.initials: RW
authors.lastname: Sanson-Fisher
authors.forename: Finlay A
authors.initials: FA
authors.lastname: Macrae
authors.forename: Catherine
authors.initials: C
authors.lastname: D'Este
authors.forename: David
authors.initials: D
authors.lastname: Hill
authors.forename: Daniel
authors.initials: D
authors.lastname: Barker
authors.forename: Jody
authors.initials: J
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003113:Colonoscopy / Q000592:standards; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005190:Family; D005260:Female; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D040941:Heredity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010375:Pedigree; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology