Journal of General Internal Medicine

, Volume 22, Issue 1, pp 121–126

Early Initiation of Colorectal Cancer Screening in Individuals with Affected First-degree Relatives

  • Harvey J. Murff
  • Neeraja B. Peterson
  • Robert A. Greevy
  • Martha J. Shrubsole
  • Wei Zheng
Populations at Risk


Several guidelines recommend initiating colorectal cancer screening at age 40 for individuals with affected first-degree relatives, yet little evidence exists describing how often these individuals receive screening procedures.


To determine the proportion of individuals in whom early initiation of colorectal cancer screening might be indicated and whether screening disparities exist.


Population-based Supplemental Cancer Control Module to the 2000 National Health Interview Survey.


Respondents, 5,564, aged 40 to 49 years were included within the analysis.


Patient self-report of sigmoidoscopy, colonoscopy, or fecal occult blood test.


Overall, 279 respondents (5.4%: 95% C.I., 4.7, 6.2) reported having a first-degree relative affected with colorectal cancer. For individuals with a positive family history, 67 whites (27.9%: 95% C.I., 21.1, 34.5) and 3 African American (9.3%: 95% C.I., 1.7, 37.9) had undergone an endoscopic procedure within the previous 10 years (P-value = .03). After adjusting for age, family history, gender, educational level, insurance status, and usual source of care, whites were more likely to be current with early initiation endoscopic screening recommendations than African Americans (OR = 1.38: 95% C.I., 1.01, 1.87). Having an affected first-degree relative with colorectal cancer appeared to have a stronger impact on endoscopic screening for whites (OR = 3.21: 95% C.I., 2.31, 4.46) than for African Americans (OR = 1.05: 95% C.I., 0.15, 7.21).


White participants with a family history are more likely to have endoscopic procedures beginning before age 50 than African Americans.

Key words

colorectal cancer family history screening prevention health disparities primary care 


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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Harvey J. Murff
    • 1
    • 2
    • 4
  • Neeraja B. Peterson
    • 1
    • 4
  • Robert A. Greevy
    • 3
  • Martha J. Shrubsole
    • 1
    • 2
    • 4
  • Wei Zheng
    • 1
    • 2
    • 4
  1. 1.Division of General Internal Medicine and Public HealthVanderbilt University Medical CenterNashvilleUSA
  2. 2.Department of Veterans AffairsVA Tennessee Valley Healthcare System, GRECCNashvilleUSA
  3. 3.Department of BiostatisticsVanderbilt University Medical CenterNashvilleUSA
  4. 4.Vanderbilt-Ingram Cancer CenterVanderbilt University Medical CenterNashvilleUSA

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