DOI QR코드

DOI QR Code

Implementation of Screening Colonoscopy amongst First-Degree Relatives of Patients with Colorectal Cancer in Turkey: a Cross-Sectional Questionnaire Based Survey

  • Adakan, Yesim (Department of Internal Medicine, Antalya Training and Research Hospital) ;
  • Taskoparan, Muharrem (Department of Gastroenterology, Ankara Guven Hospital) ;
  • Cekin, Ayhan Hilmi (Department of Gastroenterology, Antalya Training and Research Hospital) ;
  • Duman, Adil (Department of Gastroenterology, Antalya Training and Research Hospital) ;
  • Harmandar, Ferda (Department of Gastroenterology, Antalya Training and Research Hospital) ;
  • Taskin, Vildan (Department of Gastroenterology, Antalya Training and Research Hospital) ;
  • Yilmaz, Ustun (Department of Internal Medicine, Antalya Training and Research Hospital) ;
  • Yesil, Bayram (Department of Internal Medicine, Antalya Training and Research Hospital)
  • Published : 2014.07.30

Abstract

Objective: To evaluate the implementation of screening colonoscopy amongst first-degree relatives (FDRs) of patients with colorectal cancer (CRC) in Turkey. Materials and Methods: A total of 400 first-degree relatives (mean(SD)age: 42.5(12.7) years, 55.5% were male) of 136 CRC patients were included in this cross-sectional questionnaire based survey. Data on demographic characteristics, relationship to patient and family history for malignancy other than the index case were evaluated in the FDRs of patients as were the data on knowledge about and characteristics related to the implementation of screening colonoscopy using a standardized questionnaire form. Results: The mean(SD) age at diagnosis of CRC in the index patients was 60.0(14.0) years, while mean(SD) age of first degree relatives was 42.5(12.7) years. Overall 36.3% of relatives were determined to have knowledge about colonoscopy. Physicians (66.9%) were the major source of information. Screening colonoscopy was recommended to 19.5% (n=78) of patient relatives, while 48.7% (n=38) of individuals participated in colonoscopy procedures, mostly (57.9%) one year after the index diagnosis. Screening colonoscopy revealed normal findings in 25 of 38 (65.8%) cases, while precancerous lesions were detected in 26.3% of screened individuals. In 19.0% of FDRs of patients, there was a detected risk for Lynch syndrome related cancer. Conclusions: In conclusion, our findings revealed that less than 20% of FDRs of patients had received a screening colonoscopy recommendation; only 48.7% participated in the procedure with detection of precancerous lesions in 26.3%. Rise of awareness about screening colonoscopy amongst patients with CRC and first degree relatives of patients and motivation of physicians for targeted screening would improve the participation rate in screening colonoscopy by FDRs of patients with CRC in Turkey.

Keywords

References

  1. Al-Habsi H, Lim JN, Chu CE, Hewison J (2008). Factors influencing the referrals in primary care of asymptomatic patients with a family history of cancer. Genet Med, 10, 751-7. https://doi.org/10.1097/GIM.0b013e318185212a
  2. Armelao F, Paternolli C, Franceschini G, et al (2011). Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening program. Gastrointest Endosc, 73, 527-34. https://doi.org/10.1016/j.gie.2010.12.025
  3. Bleiker EM, Menko FH, Taal BG, et al (2005). Screening behavior of individuals at high risk for colorectal cancer. Gastroenterology, 128, 280-7. https://doi.org/10.1053/j.gastro.2004.11.002
  4. Bronner K, Mesters I, Weiss-Meilik A, et al (2013). Determinants of adherence to screening by colonoscopy in individuals with a family history of colorectal cancer. Patient Educ Couns, 93, 272-81. https://doi.org/10.1016/j.pec.2013.06.029
  5. Butterworth AS, Higgins JP, Pharoah P (2006). Relative and absolute risk of colorectal cancer for individuals with a family history: a meta-analysis. Eur J Cancer, 42, 216-27. https://doi.org/10.1016/j.ejca.2005.09.023
  6. Cameron E, Rose S, Carey M (2013). Assessment of family history of colorectal cancer in primary care: perceptions of first degree relatives of people with colorectal cancer". Patient Educ Couns, in press. http://dx.doi.org/10.1016/j.pec.2013.11.014
  7. Chen YS, Xu SX, Ding YB, et al (2013). Colorectal cancer screening in high-risk populations: a survey of cognition among medical professionals in Jiangsu, China. Asian Pac J Cancer Prev, 14, 6487-91. https://doi.org/10.7314/APJCP.2013.14.11.6487
  8. Chong VH, Bakar S, Sia R, et al (2013). Colorectal cancer screening among government servants in Brunei Darussalam. Asian Pac J Cancer Prev, 14, 7657-61. https://doi.org/10.7314/APJCP.2013.14.12.7657
  9. Courtney RJ, Paul CL, Carey ML, et al (2013). A populationbased cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients. BMC Cancer, 13, 13. https://doi.org/10.1186/1471-2407-13-13
  10. Denis B, Schon G, Ruetsch M, et al (2007). Cancer screening by primary care physicians: a chart audit. Presse Med, 36, 217-23. https://doi.org/10.1016/j.lpm.2006.04.001
  11. Honda K, Neugut AI (2004). Associations between perceived cancer risk and established risk factors in a national community sample. Cancer Detect Prev, 28, 1-7. https://doi.org/10.1016/j.cdp.2003.12.001
  12. Ingrand I, Dujoncquoy S, Beauchant M, et al (2009). General practitioner and specialist views on colonoscopic screening of first-degree relatives of colorectal cancer patients. Cancer Epidemiol, 33, 223-30. https://doi.org/10.1016/j.canep.2009.07.002
  13. Ioannou GN, Chapko MK, Dominitz JA (2003). Predictors of colorectal cancer screening participation in the United States. Am J Gastroenterol, 98, 2082-91. https://doi.org/10.1111/j.1572-0241.2003.07574.x
  14. Johns LE, Houlston RS (2001). A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol, 96, 2992-3003. https://doi.org/10.1111/j.1572-0241.2001.04677.x
  15. Kahi CJ, Imperiale TF, Juliar BE, et al (2009). Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol, 71, 770-5.
  16. Kilickap S, Arslan C, Rama D, Yalcin S (2012). Screening colonoscopy participation in Turkish colorectal cancer patients and their first degree relatives. Asian Pac J Cancer Prev, 13, 2829-32. https://doi.org/10.7314/APJCP.2012.13.6.2829
  17. Koo JH, Leong RW, Ching J, et al (2012). Asia pacific working group in colorectal cancer knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the Asia-Pacific region: a multicenter study. Gastrointest Endosc, 76, 126-35 https://doi.org/10.1016/j.gie.2012.03.168
  18. Levenson D (2003). CDC says colorectal cancer screening rates remain low. Rep Med Guidel Outcomes Res, 14, 10-2.
  19. Lieberman DA (1995). Cost-effectiveness model for colon cancer screening. Gastroenterology, 109, 1781-90. https://doi.org/10.1016/0016-5085(95)90744-0
  20. Lim JN, Hewison J, Chu CE, Al-Habsi H (2011). Factors influencing consultation to discuss family history of cancer by asymptomatic patients in primary care. J Community Genet, 2, 19-26. https://doi.org/10.1007/s12687-011-0034-4
  21. Longacre AV, Cramer LD, Gross CP (2006). Screening colonoscopy use among individuals at higher colorectal cancer risk. J Clin Gastroenterol, 40, 490-6. https://doi.org/10.1097/00004836-200607000-00006
  22. Lynch HT, Lynch JF, Lynch PM (2007). Towards a consensus in molecular diagnosis of hereditary non-polyposis colorectal cancer (Lynch Syndrome). J Natl Cancer Inst, 99, 261-3. https://doi.org/10.1093/jnci/djk077
  23. Turkish Ministry of Health Public Health Institute (2008). Evaluation reports by the cancer control directorate general of the turkish public health institute: colorectal cancer screening. http://www.kanser.gov.tr/Dosya/Bilgi-Dokumanlari/raporlar/kolorektal.pdf (in Turksih)
  24. Murakami R, Tsukuma H, Kanamori S, et al (1990). Natural history of colorectal polyps and the effect of polypectomy on occurrence of subsequent cancer. Int J Cancer, 46, 159-64. https://doi.org/10.1002/ijc.2910460203
  25. Muto T, Bussey HJ, Morson BC (1975). The evolution of cancer of the colon and rectum. Cancer, 36, 2251-70. https://doi.org/10.1002/cncr.2820360944
  26. Nadel MR, Blackman DK, Shapiro JA, Seeff LC (2002). Are people being screened for colorectal cancer as recommended? Results from the National Health Interview Survey. Prev Med, 35, 199-206. https://doi.org/10.1006/pmed.2002.1070
  27. Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (2002). Cancer Incidence In Five Continents, vol. VIII. Lyon, France: International Agency for Research on Cancer [IARC Scientific Publication No. 155].
  28. Rex DK, Johnson DA, Lieberman DA, Burt RW, Sonnenberg A (2000). Colorectal cancer prevention 2000. Screening recommendations of the American College of Gastroenterology. American College of Gastroenterology. Am J Gastroenterol, 95, 868-77.
  29. Ruthotto F, Papendorf F, Wegener G, et al (2007). Participation in screening colonoscopy in first-degree relatives from patients with colorectal cancer. Ann Oncol, 18, 1518-22. https://doi.org/10.1093/annonc/mdm200
  30. Schmiegel W, Pox C, Adler G et al (2004). S3-guidelines conference 'colorectal carcinoma' 2004. Z Gastroenterol, 42, 1129-77. https://doi.org/10.1055/s-2004-813699
  31. Sewitch MJ, Fournier C, Dawes M, et al (2007). Do physician recommendations for colorectal cancer screening differ by patient age? Can J Gastroenterol, 21, 435-8.
  32. Tastan S, Andsoy II, Iyigun E (2013). Evaluation of the knowledge, behavior and health beliefs of individuals over 50 regarding colorectal cancer screening. Asian Pac J Cancer Prev, 14, 5157-63. https://doi.org/10.7314/APJCP.2013.14.9.5157
  33. Vasen HF (2008). Can the identification of high risk groups increase the effectiveness of colon cancer screening programmes? Z Gastroenterol, 46, 41-42. https://doi.org/10.1055/s-2007-963483
  34. Winawer S, Fletcher R, Rex D, et al (2003). Colorectal cancer screening and surveillance: clinical guidelines and rationale- Update based on new evidence. Gastroenterology, 124, 544-60. https://doi.org/10.1053/gast.2003.50044
  35. Winawer SJ, Zauber AG, Ho MN, et al (1993). Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med, 32, 1977-81.
  36. Yusoff HM, Daud N, Noor NM, Rahim AA (2012). Participation and barriers to colorectal cancer screening in Malaysia. Asian Pac J Cancer Prev, 13, 3983-7. https://doi.org/10.7314/APJCP.2012.13.8.3983

Cited by

  1. Commentary on ‘Colonoscopy screening compliance and outcomes in patients with Lynch syndrome’ vol.17, pp.1, 2015, https://doi.org/10.1111/codi.12841
  2. Knowledge Regarding Early Detection of Cancer among Romanian Women having Relatives with Cancer vol.16, pp.3, 2015, https://doi.org/10.7314/APJCP.2015.16.3.1091