Inadequate screening and low awareness about risk factors among first-degree relatives of colorectal cancer patients

Czech version

Authors: P. Vítek ^{1, 2}; I. M. Kajzrlíková ²; J. Bureš ³; J. Chalupa ²
Authors‘ workplace: Lékařská fakulta Ostravské Univerzity v Ostravě, děkan doc. MUDr. Arnošt Martínek, CSc. ¹; Beskydské Gastrocentrum, Interní oddělení, Nemocnice Frýdek-Místek, p. o., primář MUDr. Petr Vítek ²; II. interní klinika Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. ³
Published in: Vnitř Lék 2011; 57(12): 1057-1061
Category: 70th birthday of prof. MUDr. Petr Dítě, DrSc.

Overview

Introduction:
First-degree relatives of colorectal cancer patients have higher risk of disease, thus colonoscopic screening should be started at the age of 40 in this group. Goal of the study was to assess their awareness of the colorectal cancer risk factors and their compliance with colorectal cancer screening programme.

Methods:
62 patients after colorectal cancer resection and their 67 first-degree relatives (42% out of 160 addressed) answered structured questionnaire and counselling focused on colorectal cancer risk factors, and screening participation.

Results:
Before diagnosis of colorectal cancer only 18% of colorectal cancer patients (11/62) were aware of its risk factors, after diagnosis their awareness increased to 65% (40/62, p < 0.001). Before questionnaire 46% of first-degree relatives (31/67) were aware of colorectal cancer risk factors, after counselling awareness increased to 66% (44/67, p = 0.024). 79% (53/67) of first-degree relatives were aware of their increased familial risk. 28% (19/67) of first-degree relatives enrolled for colorectal cancer screening. Most frequent screening method was fecal occult blood test (FOBT) in 21% (14/67) of first-degree relatives, colonoscopy was performed only in 7% (8/67) of first-degree relatives. Average age of screening participation was 53 years. 22% (15/67) of first-degree relatives refused any screening in the future.

Conclusions:
We have found low awareness of colorectal cancer risk factors in colorectal cancer patients and their relatives before their diagnosis of disease respectively before their counselling. First-degree relatives are aware of their increased risk, however their screening participation is unsatisfactory. Screening is performed only in minority of first-degree relatives, often late and with inappropriate modality (FOBT). 22% of first-degree relatives refused any screening in spite of their increased colorectal cancer risk.

Key words:
colorectal neoplasms – screening – risk factors – family history

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