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Patient Educ Couns. 2013 Nov;93(2):272-81. doi: 10.1016/j.pec.2013.06.029. Epub 2013 Aug 2.

Determinants of adherence to screening by colonoscopy in individuals with a family history of colorectal cancer.

Author information

1
The Department of Gastroenterology and Liver Diseases, The Tel Aviv Sourasky Medical Center, Israel. Electronic address: karenb@tlvmc.gov.il.

Abstract

OBJECTIVE:

Although first-degree relatives (FDRs) of colorectal cancer (CRC) patients, as a high-risk population, have the most to gain from colonoscopy screening, their adherence is suboptimal. Thus, an assessment of the determinants of adherence to screening is of potential importance.

METHODS:

A cross-sectional study was conducted among 318 FDRs of 164 CRC patients treated at Tel-Aviv Sourasky Medical Center. Interviews were conducted with a questionnaire using I-Change Model.

RESULTS:

Adherence to interval colonoscopy was low with only 73 FDRs (23.0%). Greater adherence was associated with socio-demographic variables (older age, siblings, having spouse, higher level of education and income) and behavioral variables (healthier lifestyle, utilization of preventive health services). Family physicians and kin were identified as the most influential figures on uptake. Intention, affective barriers, positive attitudes, social support, cues to action, age, and health maintenance were the strongest determinants of participation in CRC screening.

CONCLUSION:

Adherence to colonoscopy is determined by multiple variables. Medical staff can play a key role in increasing adherence to colonoscopy.

PRACTICE IMPLICATIONS:

Future interventions should focus on fostering positive attitudes, overcoming barriers, enhancing social support and providing a medical recommendation. Special efforts should be invested in young FDRs, those of low socio-economic status and those who underutilize preventive medicine.

KEYWORDS:

Adherence; CRC; CTC; Colonoscopy screening; Colorectal cancer prevention; Determinants; FDRs; FOBT; First-degree-relatives; colorectal cancer; computerized tomographic colonography; fecal occult blood test; first-degree relatives

PMID:
23916675
DOI:
10.1016/j.pec.2013.06.029
[Indexed for MEDLINE]
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