Annals of Surgical Oncology

, Volume 16, Issue 8, pp 2092–2100 | Cite as

Colorectal Cancer Screening Among First-Degree Relatives of Colorectal Cancer Patients: Benefits and Barriers

  • Lloyd A. Mack
  • Linda S. Cook
  • Walley J. Temple
  • Linda E. Carlson
  • Robert J. Hilsden
  • Elizabeth Oddone Paolucci
Healthcare Policy and Outcomes



Individuals with a first-degree family history of colorectal cancer (CRC) are at increased risk of CRC. Study objectives were: (1) to estimate the proportion of first-degree relatives (FDR) of CRC patients being screened for CRC and (2) to identify predictors of screened behavior.


A questionnaire was mailed to 640 stage I–III CRC patients from a population-based registry to identify FDR. A survey was sent to 747 FDR, aged 40 or older, to assess CRC screening, knowledge, demographics, access, benefits, and barriers of CRC screening. Factor analysis was used to detect underlying constructs. Predictors of screening were explored by multivariate analysis (MVA).


There was a 54% and 51% response for patients and FDR, respectively. Among FDR, 86% were born in Canada, 94% spoke English, 93.5% had a high school education, 73% were married, and 55% were employed. The age distribution was: 40–44 years (19.7%), 45–49 (19.1%), 50–54 (16%), 55–59 (15.2%), 60–64 (9.8%), and >65 (18%). Seventy percent had undergone CRC screening with 60% adherent to current guidelines. Of those screened, 33.7% had fecal occult blood testing, 19.4% had barium enema, 10.7% had sigmoidoscopy, and 58.7% had colonoscopy. Five constructs influencing CRC screening include: salience and coherence, perceived susceptibility, response efficacy, social influence, and cancer worries. MVA determined age >50 years as the most important predictor of screening.


In this survey, 70% of FDR of CRC patients had undergone screening; age was the most important predictor. Understanding underlying constructs influencing screening behavior may improve uptake of CRC screening in this population.


Fecal Occult Blood Testing Colorectal Cancer Screening Cancer Worry Response Efficacy General Population Survey 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to acknowledge the helpful discussions regarding study design and analysis with Alberta Cancer Registry Staff as well as Dr. Elizabeth McGregor and Dr. Bejoy Thomas.


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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Lloyd A. Mack
    • 1
  • Linda S. Cook
    • 2
  • Walley J. Temple
    • 1
  • Linda E. Carlson
    • 3
  • Robert J. Hilsden
    • 4
  • Elizabeth Oddone Paolucci
    • 5
  1. 1.Department of Surgery and OncologyUniversity of CalgaryCalgaryCanada
  2. 2.Department of Internal MedicineUniversity of New MexicoAlbuquerqueUSA
  3. 3.Department of OncologyUniversity of CalgaryCalgaryCanada
  4. 4.Department of Medicine and Community Health SciencesUniversity of CalgaryCalgaryCanada
  5. 5.Department of SurgeryUniversity of CalgaryCalgaryCanada

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