title: Adherence to colonoscopy recommendations for first-degree relatives of young patients diagnosed with colorectal cancer.
abstract: OBJECTIVE
  Colorectal cancer is the third leading cause of cancer death in the United States. The American College of Gastroenterology recommends screening for first-degree relatives of patients diagnosed with colorectal cancer before the age of 50. A colonoscopy is one of the most commonly recommended exams due to its specificity and the possibility to resect pre-malignant lesions. Nevertheless, the rate of physician adherence to this recommendation is unknown.
  
  
  METHODS
  This transversal study was performed at a major cancer center in Brazil with 62 patients, aged 18 to 50, who completed a questionnaire on information received from their physicians regarding screening their first-degree relatives. We used the answers from patients who provided explicit consent.
  
  
  RESULTS
  Two hundred and three patients were eligible to participate and 93 (45.8%) agreed to complete the questionnaire. Twenty-three questionnaires (24.73%) were returned and 39 were completed by telephone. Of the patients who answered the questionnaire, 39 (62.9%) had received a colonoscopy recommendation for their first-degree relatives and 23 (37.1%) were not informed of the recommendation. Among the patients who received the recommendations, 20.51% affirmed that all relatives completed the exam and 51.28% stated that no relatives completed the exam.
  
  
  CONCLUSIONS
  The adherence rate of our physicians to the ACG guideline recommendations was 62.9%. Considering that our study was performed at a leading center for cancer treatment in Latin America, we had expected better adherence. The results show that adherence to the colorectal cancer screening recommendations for high-risk patients must be improved.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Guilherme H
authors.initials: GH
authors.lastname: Garcia
authors.affiliation: Instituto do Cancer do Estado de São Paulo, São Paulo, SP, Brazil.
authors.forename: Rachel P
authors.initials: RP
authors.lastname: Riechelmann
authors.affiliation: Instituto do Cancer do Estado de São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Hoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D005190:Family; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult