Poor patient knowledge regarding family history of colon polyps: implications for the feasibility of stratified screening recommendations

Background: In 2008, the American College of Gastroenterology (ACG) modified its colorectal screening guidelines regarding patients with family histories of colorectal polyps, specifically highlighting the importance of obtaining detailed history that includes the number, type, and size of adenomas found in a patient's relative. This information is then used to guide screening recommendations for these patients.

Objective: To assess the proportion of patients undergoing screening colonscopy for a family history of polyps who have knowledge of their family members' colonoscopy findings.

Design: Retrospective, single-center cohort pilot study.

Setting: Tertiary care medical center.

Patients: Patients who presented for screening colonoscopy between 2008 and 2010 with an indication of family history of polyps.

Interventions: Obtain detailed history regarding patient's family history of polyps, including which family member, age of family member at diagnosis, size, type and number of polyps found.

Main outcome measurements: Knowledge of family history.

Results: Seventy-three patients were included in the study. Their knowledge of their family histories of polyps showed the following: 23.2% (17/73; 95% CI, 14%-35%) did not know which family member had polyps, 42.5% (31/73; 95% CI, 31%-55%) did not know the age at diagnosis, 71.2% (52/73; 95% CI, 59%-81%) did not know the polyp type, 90.4% (66/73; 95% CI, 81%-96%) did not know the number of polyps found, and 97.3% (71/73; 95% CI, 90%-100%) did not know the polyp size.

Limitations: Retrospective study at a single tertiary referral center.

Conclusions: Patients' knowledge regarding the details of their family histories of polyp data appears often unknown or incomplete. Thus, at present, it may not appear feasible or practical to incorporate this level of information in colon cancer screening guidelines.