Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer

Bujanda, Luis; Sarasqueta, Cristina; Zubiaurre, Leire; Cosme, Angel; Muñoz, Carmen; Sánchez, Araceli; Martín, Cristina; Tito, Ilucia; Piñol, Virginia; Castells, Antoni; Llor, Xavier; Xicola, Rosa M.; Pons, Elisenda; Clofent, Juan; de Castro, Maria L.; Cuquerella, Jaime; Medina, Enrique; Gutierrez, Ana; Arenas, Juan I.; Jover, Rodrigo
December 2007
Gut;Dec2007, Vol. 56 Issue 12, p1714
Academic Journal
Background: Colonoscopy is one of the methods of choice for screening relatives of patients with colorectal cancer. Objective: To evaluate the rate of adherence to colonoscopy in first-degree relatives of patients with colorectal cancer and describe the lesions found. Methods: A prospective, cross-sectional, multicentre, nationwide study was conducted. The study population was composed of first-degree relatives of patients with colorectal cancer selected randomly from the EPICOLON study. Seventy-four index patients were included. These had 342 living first-degree relatives (parents, siblings and children), of whom 281 were interviewed. Results: The adherence rate was 38% (107/281). Adherence was greater in families with a higher degree of familial aggregation for colorectal cancer (88.9% for Amsterdam vs 33.3% for Bethesda and sporadic cancer; p<0.05), an index patient aged under 65 years (60% for patients <65 years vs 32.9% for patients ⩾65 years; p<0.05) and an index patient who was female (46.2% for women vs 31% for men; p=0.28). Adherence was also greater in relatives under 65 years (54% in patients <65 years vs 18% in patients ⩾65 years; p=0.05), in female relatives (49% in female relatives vs 27.3% in male relatives; p<0.05) and in siblings and children (40% in siblings and children vs 13% in parents; p<0.05). Lesions were found in 26% (28/107) of the study population. Nine (8.4%) individuals had a total of 18 advanced lesions. Conclusions: These results indicate that adherence to colonoscopy in our population of first-degree relatives was low. The adherence was more frequently associated with a higher degree of familial aggregation, a relative age of under 65 years, a sibling or offspring relationship, and female sex.


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