title: Determinants of adherence to screening by colonoscopy in individuals with a family history of colorectal cancer.
abstract: OBJECTIVE
  Although first-degree relatives (FDRs) of colorectal cancer (CRC) patients, as a high-risk population, have the most to gain from colonoscopy screening, their adherence is suboptimal. Thus, an assessment of the determinants of adherence to screening is of potential importance.
  
  
  METHODS
  A cross-sectional study was conducted among 318 FDRs of 164 CRC patients treated at Tel-Aviv Sourasky Medical Center. Interviews were conducted with a questionnaire using I-Change Model.
  
  
  RESULTS
  Adherence to interval colonoscopy was low with only 73 FDRs (23.0%). Greater adherence was associated with socio-demographic variables (older age, siblings, having spouse, higher level of education and income) and behavioral variables (healthier lifestyle, utilization of preventive health services). Family physicians and kin were identified as the most influential figures on uptake. Intention, affective barriers, positive attitudes, social support, cues to action, age, and health maintenance were the strongest determinants of participation in CRC screening.
  
  
  CONCLUSIONS
  Adherence to colonoscopy is determined by multiple variables. Medical staff can play a key role in increasing adherence to colonoscopy.
  
  
  CONCLUSIONS
  Future interventions should focus on fostering positive attitudes, overcoming barriers, enhancing social support and providing a medical recommendation. Special efforts should be invested in young FDRs, those of low socio-economic status and those who underutilize preventive medicine.
authors.affiliation: The Department of Gastroenterology and Liver Diseases, The Tel Aviv Sourasky Medical Center, Israel. Electronic address: karenb@tlvmc.gov.il.
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-Meilik
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; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Adherence; CRC; CTC; Colonoscopy screening; Colorectal cancer prevention; Determinants; FDRs; FOBT; First-degree-relatives; colorectal cancer; computerized tomographic colonography; fecal occult blood test; first-degree relatives