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Open Access Highly Accessed Research article

Colorectal cancer risk assessment and screening recommendation: a community survey of healthcare providers' practice from a patient perspective

Ryan J Courtney14*, Christine L Paul34, Robert W Sanson-Fisher4, Finlay A Macrae2, Mariko L Carey4, John Attia4 and Mark McEvoy4

Author Affiliations

1 The Priority Research Centre for Health Behaviour, School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Newcastle, Australia

2 Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Newcastle, Australia

3 The Centre for Clinical Epidemiology and Biostatistics, Faculty of Health, The University of Newcastle, Newcastle, Australia

4 Hunter Medical Research Institute, Newcastle, Australia

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BMC Family Practice 2012, 13:17  doi:10.1186/1471-2296-13-17

Published: 14 March 2012

Abstract

Background

Family history is a common risk factor for colorectal cancer (CRC), yet it is often underused to guide risk assessment and the provision of risk-appropriate CRC screening recommendation. The aim of this study was to identify from a patient perspective health care providers' current practice relating to: (i) assessment of family history of CRC; (ii) notification of "increased risk" to patients at "moderately/potentially high" familial risk; and (iii) recommendation that patients undertake CRC screening.

Methods

1592 persons aged 56-88 years randomly selected from the Hunter Community Study (HCS), New South Wales, Australia were mailed a questionnaire. 1117 participants (70%) returned a questionnaire.

Results

Thirty eight percent of respondents reported ever being asked about their family history of CRC. Ever discussing family history of CRC with a health care provider was significantly more likely to occur for persons with a higher level of education, who had ever received screening advice and with a lower physical component summary score. Fifty one percent of persons at "moderately/potentially high risk" were notified of their "increased risk" of developing CRC. Thirty one percent of persons across each level of risk had ever received CRC screening advice from a health care provider. Screening advice provision was significantly more likely to occur for persons who had ever discussed their family history of CRC with a health care provider and who were at "moderately/potentially high risk".

Conclusions

Effective interventions that integrate both the assessment and notification of familial risk of CRC to the wider population are needed. Systematic and cost-effective mechanisms that facilitate family history collection, risk assessment and provision of screening advice within the primary health care setting are required.