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Open Access Research article

A population-based cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients

Ryan J Courtney147*, Christine L Paul14, Mariko L Carey14, Robert W Sanson-Fisher14, Finlay A Macrae2, Catherine D’Este3, David Hill5, Daniel Barker3 and Jody Simmons6

Author Affiliations

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

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

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

4 Hunter Medical Research Institute, University of Newcastle, Callaghan, Australia

5 Professorial Fellow, University of Melbourne, Melbourne, Australia

6 Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia

7 Priority Research Centre for Health Behaviour, University of Newcastle, Room 269a, Level 2, David Maddison Building, Callaghan, 2308, Australia

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BMC Cancer 2013, 13:13  doi:10.1186/1471-2407-13-13

Published: 10 January 2013

Abstract

Background

The aim of this study was to determine the proportions and predictors of first-degree relatives (FDRs) of colorectal cancer (CRC) patients (i) ever receiving any CRC testing and (ii) receiving CRC screening in accordance with CRC screening guidelines.

Methods

Colorectal cancer patients and their FDRs were recruited through the population-based Victorian Cancer Registry, Victoria, Australia. Seven hundred and seven FDRs completed telephone interviews. Of these, 405 FDRs were deemed asymptomatic and eligible for analysis.

Results

Sixty-nine percent of FDRs had ever received any CRC testing. First-degree relatives of older age, those with private health insurance, siblings and FDRs who had ever been asked about family history of CRC by a doctor were significantly more likely than their counterparts to have ever received CRC testing. Twenty-five percent of FDRs “at or slightly above average risk” were adherent to CRC screening guidelines. For this group, adherence to guideline-recommended screening was significantly more likely to occur for male FDRs and those with a higher level of education. For persons at “moderately increased risk” and “potentially high risk”, 47% and 49% respectively adhered to CRC screening guidelines. For this group, guideline-recommended screening was significantly more likely to occur for FDRs who were living in metropolitan areas, siblings, those married or partnered and those ever asked about family history of CRC.

Conclusions

A significant level of non-compliance with screening guidelines was evident among FDRs. Improved CRC screening in accordance with guidelines and effective systematic interventions to increase screening rates among population groups experiencing inequality are needed.

Trial Registration

Australian and New Zealand Clinical Trial Registry: ACTRN12609000628246

Keywords:
Colorectal cancer; Screening; Prevention; Early detection; Family history