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Low adherence to colonoscopy in the screening of first-degree relatives of patients with colorectal cancer
  1. Luis Bujanda1,
  2. Cristina Sarasqueta1,
  3. Leire Zubiaurre1,
  4. Angel Cosme1,
  5. Carmen Muñoz2,
  6. Araceli Sánchez2,
  7. Cristina Martín3,
  8. Llucia Tito3,
  9. Virginia Piñol4,
  10. Antoni Castells4,
  11. Xavier Llor5,
  12. Rosa M Xicola5,
  13. Elisenda Pons5,
  14. Juan Clofent6,
  15. María L de Castro6,
  16. Jaime Cuquerella7,
  17. Enrique Medina7,
  18. Ana Gutierrez8,
  19. Juan I Arenas1,
  20. Rodrigo Jover8
  1. 1
    Department of Gastroenterology, Donostia Hospital, San Sebastian, Spain
  2. 2
    San Eloy Hospital, Baracaldo, Spain
  3. 3
    l’Esperit Sant de Santa Coloma de Gramanet Hospital, Spain
  4. 4
    Clinic Hospital-CIBEREHD, Barcelona, Spain
  5. 5
    Trias i Pujol Hospital, Badalona, Spain
  6. 6
    Meixoeiro Hospital, Vigo, Spain
  7. 7
    General Hospital, Valencia, Spain
  8. 8
    General Hospital, Alicante, Spain
  1. Luis Bujanda, Avda Sancho El Sabio, 21–3°C, 20010 San Sebastián, Spain; medik{at}


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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  • Principal investigators in the EPICOLON Group are listed in the Appendix.

  • Competing interests: None.

  • Abbreviation:
    computed tomography