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

  • Populations at Risk
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Background

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.

Objectives

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

Design

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

Participants

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

Measurements

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

Results

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).

Conclusions

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

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Acknowledgement

The authors would like to acknowledge the Department of Veterans Affairs, Tennessee Valley Healthcare System, GRECC for its administrative support in the preparation of the manuscript.

Financial Support

Dr. Murff is supported by a Career Development Award through the Vanderbilt-Ingram Cancer Center SPORE in GI Cancer Grant (CA 95103) and is a VA Clinical Research Scholar, VA Clinical Research Center of Excellence. The funding organization had no role in the design or conduct of the study, interpretation of the data, and preparation or approval of the manuscript.

Potential Financial Conflicts of Interest

None disclosed.

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Authors and Affiliations

  1. Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA

    Harvey J. Murff MD, MPH, Neeraja B. Peterson MD, MSc, Martha J. Shrubsole PhD & Wei Zheng MD, PhD, MPH

  2. Department of Veterans Affairs, VA Tennessee Valley Healthcare System, GRECC, 1310 24th Avenue South, Nashville, TN, 37212-5381, USA

    Harvey J. Murff MD, MPH, Martha J. Shrubsole PhD & Wei Zheng MD, PhD, MPH

  3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA

    Robert A. Greevy PhD

  4. Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA

    Harvey J. Murff MD, MPH, Neeraja B. Peterson MD, MSc, Martha J. Shrubsole PhD & Wei Zheng MD, PhD, MPH

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  1. Harvey J. Murff MD, MPH
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  2. Neeraja B. Peterson MD, MSc
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Correspondence to Harvey J. Murff MD, MPH.

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Murff, H.J., Peterson, N.B., Greevy, R.A. et al. Early Initiation of Colorectal Cancer Screening in Individuals with Affected First-degree Relatives. J GEN INTERN MED 22, 121–126 (2007). https://doi.org/10.1007/s11606-007-0115-6

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  • DOI: https://doi.org/10.1007/s11606-007-0115-6

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