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Increased risk in first-degree relatives with colorectal cancer - is communication between physicians, colorectal cancer - patients and first-degree relatives sufficient in (eastern) Switzerland ?
Conference Paper/Poster - Sep 20, 2012
Sawatzki Mikael
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Background:
Colorectal cancer (CRC) contributes significantly to the global burden of cancer [1], and familial clustering of CRC is also common, a estimates proportion up to 5% of the population have a first-degree relative (FDR) with CRC [2, 3]. Those with one first-degree relative experience a 2-fold higher risk of CRC, those with two or more relatives, a 3-4-fold increased risk, independent of age at diagnosis [4]. But is the communication between physicians and surgeons sufficient in alerting CRC-patients and their first-degree relatives to undergo a screening colonoscopy ?
Methods:
We consulted in a retrospective single center cohort all index-patients aged 18-80 who underwent surgery for CRC between January 2004 and May 2010 (64 months) at Kantonsspital St. Gallen with a questionnaire. Patients with hereditary syndromes were excluded. After written approval by the index patients, we contacted their FDR (siblings and children) to fill out a question¬naire. We examined the rate of educated index patients and FDR about the higher CRC risk (with specification of the educator) and the rate of already realised screening colonoscopy by FDR. The study was approved by the local ethical committee.
Results:
The questionnaire return rates of index patients were 34.4% (134/390, median age 66.1, male66,4%) and 69,7% (168/241, median age 43,5, male 50,6%) for their FDR (49 siblings and 119 children). 82.1% (110/134) of index patients were informed about the increased CRC risk of their FDR. 85.1% (143/168) of FDR were informed about their increased CRC risk, but 69% of all (respectively 40.8% of those aged > 50 y) did not undergo a screening colonoscopy.
Conclusions:
CRC patients and their FDR are well informed about the increased CRC risk of FDR. However, the majority of FDR do not undergo the recommended screening colonoscopy. Therefore further investigation is needed.