Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer
- Luis Bujanda1,
- Cristina Sarasqueta1,
- Leire Zubiaurre1,
- Angel Cosme1,
- Carmen Muñoz2,
- Araceli Sánchez2,
- Cristina Martín3,
- Llucia Tito3,
- Virginia Piñol4,
- Antoni Castells4,
- Xavier Llor5,
- Rosa M Xicola5,
- Elisenda Pons5,
- Juan Clofent6,
- María L de Castro6,
- Jaime Cuquerella7,
- Enrique Medina7,
- Ana Gutierrez8,
- Juan I Arenas1,
- Rodrigo Jover8
- 1Department of Gastroenterology, Donostia Hospital, San Sebastian, Spain
- 2San Eloy Hospital, Baracaldo, Spain
- 3l’Esperit Sant de Santa Coloma de Gramanet Hospital, Spain
- 4Clinic Hospital-CIBEREHD, Barcelona, Spain
- 5Trias i Pujol Hospital, Badalona, Spain
- 6Meixoeiro Hospital, Vigo, Spain
- 7General Hospital, Valencia, Spain
- 8General Hospital, Alicante, Spain
- Luis Bujanda, Avda Sancho El Sabio, 21–3°C, 20010 San Sebastián, Spain;
- Revised 21 March 2007
- Accepted 25 March 2007
- Published Online First 30 March 2007
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.
Principal investigators in the EPICOLON Group are listed in the Appendix.
Competing interests: None.
- computed tomography