Published online Dec 10, 2015. doi: 10.4253/wjge.v7.i18.1300
Peer-review started: July 24, 2015
First decision: August 25, 2015
Revised: September 18, 2015
Accepted: October 23, 2015
Article in press: October 27, 2015
Published online: December 10, 2015
Processing time: 138 Days and 15.5 Hours
AIM: To determine compliance to colorectal cancer (CRC) screening guidelines among persons with a family history of any type of cancer and investigate racial differences in screening compliance.
METHODS: We used the 2007 Health Information National Trends Survey and identified 1094 (27.4%) respondents (weighted population size = 21959672) without a family history of cancer and 3138 (72.6%) respondents (weighted population size = 58201479) with a family history of cancer who were 50 years and older. We defined compliance with CRC screening as the use of fecal occult blood testing within 1 year, sigmoidoscopy within 5 years, or colonoscopy within 10 years. We compared compliance with CRC screening among those with and without a family member with a history of cancer.
RESULTS: Overall, those with a family member with cancer were more likely to be compliant with CRC screening (64.9% vs 55.1%; OR = 1.45; 95%CI: 1.20-1.74). The absolute increase in screening rates associated with family history of cancer was 8.2% among whites. Hispanics had lowest screening rates among those without family history of cancer 41.9% but had highest absolute increase (14.7%) in CRC screening rate when they have a family member with cancer. Blacks had the lowest absolute increase in CRC screening (5.3%) when a family member has a known history of cancer. However, the noted increase in screening rates among blacks and Hispanics when they have a family member with cancer were not higher than whites without a family history of cancer: (54.5% vs 58.7%; OR = 1.16; 95%CI: 0.72-1.88) for blacks and (56.7% vs 58.7%; OR = 1.25; 95%CI: 0.72-2.18) for Hispanics.
CONCLUSION: While adults with a family history of any cancer were more likely to be compliant with CRC screening guidelines irrespective of race/ethnicity, blacks and Hispanics with a family history of cancer were less likely to be compliant than whites without a family history. Increased burden from CRC among blacks may be related to poor uptake of screening among high-risk groups.
Core tip: It is unclear whether suboptimal screening contributes to the increased risk of cancer within families. We evaluated compliance with colon cancer screening guidelines among adults in the United States. Our study suggested that adults with a family history of any cancer had higher screening rates, but the smallest increase was noted among blacks. Overall, screening was lower among blacks and Hispanics to such an extent that screening among those with a family member with cancer was not higher than screening among whites without a family member with cancer. There is a particular need to improve screening among high risk blacks.