Discussion of First-Degree Relatives’ Colorectal Cancer Risk: Survivors’ Perspectives

Abstract

Although screening reduces colorectal cancer (CRC) incidence and mortality, screening rates are low, particularly among CRC patients' first-degree relatives (FDRs). Little is known about discussion of family members' risk of CRC among patients and their health care providers or with their FDRs. The purpose of this research, guided by the Protection Motivation Theory, was to assess patients' patterns of disclosure of CRC diagnosis to adult siblings and/or children and discussion of familial risk by healthcare providers. A cross-sectional sample of patients who received care at a comprehensive cancer center was recruited to complete telephone-based interviews related to disclosure of CRC diagnosis to FDRs, recall of physician counseling about familial risk, and patients' perception of CRC risk to FDRs. Sixty-nine patients completed the interview. Most participants (n = 67, 97%) had informed their adult children or siblings of their CRC diagnosis to keep their family informed of their health status (n = 15, 22%) and to encourage FDRs to screen for CRC (n = 14, 20%). More than half of the participants' physicians (n = 38, 55%) discussed FDRs' risk of developing CRC with the patient. However, a substantial proportion of patients reported no physician discussion of this risk (n = 28, 41%). Data from this study may guide the development of interventions to facilitate physician discussion and counseling of CRC patients about their FDRs' risk for CRC. However, future studies should explore whether FDRs are likely to be screened after becoming aware of their family member's diagnosis of CRC.

Factors Associated With Colorectal Cancer Screening Among First-Degree Relatives of Patients With Colorectal Cancer in China

“…In 1 study, although respondents realized the threat of CRC, they thought they were doomed to develop the disease, rather than believing they could take control; hence, they considered early screening pointless and refused to undergo colonoscopy 39 . Family cancer events had a considerable impact in raising awareness of the risk due to family history 36,40,41 . Indeed, a risk counseling intervention focused on family history found that family-oriented interventions could significantly increase screening adherence 42 .…”

“…39 Family cancer events had a considerable impact in raising awareness of the risk due to family history. 36,40,41 Indeed, a risk counseling intervention focused on family history found that family-oriented interventions could significantly increase screening adherence. 42 Therefore, health professionals can provide health education to FDRs who are at a high risk and accessible in the hospitals while they accompany patients with CRC for medical treatment.…”