Screening patients with a family history of colorectal cancer

被引:33
作者
Fletcher, Robert H.
Lobb, Rebecca
Bauer, Mark R.
Kemp, James Alan
Palmer, Richard C.
Kleinman, Ken P.
Miroshnik, Irina
Emmons, Karen M.
机构
[1] Harvard Univ, Sch Med, Dept Ambulatory Care & Prevent, Harvard Pilgrim Hlth Care, Boston, MA 02115 USA
[2] Harvard Univ, Harvard Vanguard Med Associates, Boston, MA 02115 USA
[3] Dana Farber Canc Inst, Boston, MA 02115 USA
关键词
family history; colorectal cancer; genetic; risk; PRIMARY-CARE PHYSICIANS; PREFERENCES; RISK; INDIVIDUALS; GUIDELINES; ATTITUDES; ACCURACY; TESTS;
D O I
10.1007/s11606-007-0135-2
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
OBJECTIVES: To compare screening practices and beliefs in patients with and without a clinically important family history. DESIGN: We mailed a brief questionnaire asking about family history and a second, longer survey asking about knowledge of and beliefs about colorectal cancer to all respondents with a family history and a random sample of respondents without a family history of colorectal cancer. We reviewed electronic medical records for screening examinations and recording of family history. PARTICIPANTS: One thousand eight hundred seventy of 6,807 randomly selected patients ages 35-55 years who had been continuously enrolled in a large multispecialty group practice for at least 5 years. MEASUREMENTS: Recognition of increased risk, screening practices, and beliefs-all according to strength of family history and patient's age. RESULTS: Nineteen percent of respondents reported a family history of colorectal cancer. In 11%, this history was strong enough to warrant screening before age 50 years. However, only 39% (95% CI 36, 42) of respondents under the age of 50 years said they had been asked about family history and only 45% of those with a strong family history of colorectal cancer had been screened appropriately. Forty-six percent of patients with a strong family history did not know that they should be screened at a younger age than average risk people. Medical records mentioned family history of colorectal cancer in 59% of patients reporting a family history. CONCLUSIONS: More efforts are needed to translate information about family history of colorectal cancer into the care of patients.
引用
收藏
页码:508 / 513
页数:6
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