title: Do individuals with a family history of colorectal cancer adhere to medical recommendations for the prevention of colorectal cancer?
abstract: Individuals with a family history of colorectal cancer (CRC), have a two-to-five-fold increased lifetime risk to develop CRC. Thus, they are particularly likely to benefit from adherence to medical recommendations for CRC prevention. Despite this increased risk, previous studies have shown an underutilization of colonoscopy for screening and a paucity of data on lifestyle habits that could enhance colonoscopy rates in this population. The primary aims were (a) to assess CRC screening patterns and lifestyle choices among siblings and children of CRC patients, (b) to ascertain discrepancies between actual behavior and medical recommendations, and (c) to identify family members with multiple unhealthy lifestyle habits. The secondary aim was to test for possible associations between utilization rates for CRC screening and other preventive health services. A cross-sectional study was conducted among 318 first-degree relatives (FDRs) of 164 CRC patients treated at the Tel Aviv Sourasky Medical Center. Interviews were conducted with a structured questionnaire. There was significant underutilization of colonoscopy for screening with only 73 FDRs (23.0%) adhering to the recommended screening schedule. This rate was slightly improved (N = 58, 31.9%) among subjects aged 40 years and above, although it was still far below the optimum. A similar result (N = 70, 21.7%) was observed for other cancer screening tests and routine medical check-ups. A significant association (P < 0.0001) was found for healthful lifestyles, overall use of preventive health services, and adherence to CRC screening recommendations. CRC screening is significantly underutilized among FDRs of CRC patients. FDRs who do not comply with CRC screening guidelines, lead unhealthy lifestyles, and avoid other cancer screening tests are at increased risk and should be addressed specifically in future interventions.
authors.affiliation: Service of Gastrointestinal Malignancies, Department of Gastroenterology and Liver Disease, The Tel Aviv Sourasky Medical Center, Weizmann St., 64239, Tel Aviv, Israel.
authors.forename: Karen
authors.initials: K
authors.lastname: Bronner
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.forename: Ahuva
authors.initials: A
authors.lastname: Weiss-Meilnik
authors.forename: Ravit
authors.initials: R
authors.lastname: Geva
authors.forename: Guy
authors.initials: G
authors.lastname: Rozner
authors.forename: Hana
authors.initials: H
authors.lastname: Strul
authors.forename: Moshe
authors.initials: M
authors.lastname: Inbar
authors.forename: Zamir
authors.initials: Z
authors.lastname: Halpern
authors.forename: Revital
authors.initials: R
authors.lastname: Kariv
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000235:genetics / Q000517:prevention & control* / Q000523:psychology; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D011379:Prognosis; D035781:Siblings; D055815:Young Adult
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