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Invitation to Screening Colonoscopy in the Population at Familial Risk for Colorectal Cancer.

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  • 1Institute for General Medicine, Faculty of Medicine, University of Halle-Wittenberg, Halle; Institute for Health and Nursing Sciences, Faculty of Medicine, University of Halle-Wittenberg, Halle; Director Emeritus, Department of Medicine C, Ludwigshafen Hospital, c/o LebensBlicke Foundation, Ludwigshafen; Department of Internal Medicine I, Ulm University Hospital, Ulm; Department of Medicine I, Braunschweig Municipal Hospital, Braunschweig; Department of Gastroenterology, Celle General Hospital, Celle; Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen; Faculty of Human and Health Sciences, University of Bremen; Institute for Medical Epidemiology, Biometrics, and Information Science, Faculty of Medicine, University of Halle-Wittenberg, Halle; Nursing Research Unit, Halle University Hospital, Halle: Madeleine Ritter-Herschbach, MScN, RN; Department for Health, University of Bath, Claverton Down, Bath, UK.

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|December 7, 2018
PubMed
Summary

Targeted outreach to first-degree relatives of colorectal cancer (CRC) patients increased screening colonoscopy participation. This highlights the importance of screening high-risk family members for early detection of neoplasia.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Preventive Medicine

Background:

  • Screening colonoscopy significantly reduces colorectal cancer (CRC) incidence.
  • Participation in CRC screening remains low, even among high-risk individuals.
  • Familial risk is a key factor influencing CRC development.

Purpose of the Study:

  • To investigate methods to double screening colonoscopy participation among individuals with a familial risk of CRC.
  • To determine the frequency of neoplastic findings in this high-risk group.

Main Methods:

  • A nationwide, cluster-randomized, multicenter study was conducted in Germany.
  • First-degree relatives (FDR) of CRC patients received informational materials and colonoscopy invitations.
  • An intervention group received additional telephone counseling from nurses.

Main Results:

  • Colonoscopy uptake was 79% in the intervention group and 71% in the control group (RR = 1.11).
  • Polypectomy was performed in 37% of asymptomatic individuals; advanced neoplasia was detected in 7%.
  • Two cases of colon cancer (stages T0 and T1) were identified.

Conclusions:

  • Telephone counseling by nurses did not significantly increase colonoscopy participation rates.
  • Engaging patients with CRC presents an opportunity to increase screening participation among their FDRs.
  • The high frequency of neoplasia detected emphasizes the need for early screening of relatives, potentially before the standard age threshold.