Surveillance behavior of women with a reported family history of colorectal cancer

Study objective. The present study tested whether the surveillance behavior of women with a family history of colorectal cancer (CRC) differed from that of women without such a history. Design. The study included 72,710 subjects from the population of E3N, a cohort study, part of the European Prospective Investigation on Cancer, investigating risk factors for cancer among women. Results. Fecal occult-blood testing (FOBT) was reported by 19.4% of the women with no CRC in their family and by 21.8% of those with one or more CRC (frequency odds ratio (FOR) = 1.01; ns). The degree of kinship did not influence FOBT. Colonoscopy was reported by 10.9% of women with no CRC in their family; its frequency increased with increasing number of subjects affected by CRC in the family, in particular when it concerned first-degree relatives. Colonoscopy was reported almost four times more frequently by subjects having two or more first degree relatives with CRC (FOR = 3.55; 95%CI 2.47-5.10) than by those without any affected member; the frequency of colonoscopy increased, though less sharply, among women with second-degree affected relatives, compared with those without any affected relative in their family. Conclusion. In conclusion, whereas FOBT was unaffected by family history of CRC, screening colonoscopy was more frequent among women with a reported family history and differed with the degree of kinship of the affected relatives. The high rate of colonoscopy observed among subjects with first- and second-degree relatives is likely due to physician participation in screening decisions. (C) 1999 American Health Foundation and Academic Press.