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Colonoscopy Screening Among US Adults Aged 40 or Older With a Family History of Colorectal Cancer

Colonoscopy Screening Among US Adults Aged 40 or Older With a Family History of Colorectal Cancer

ORIGINAL RESEARCH — Volume 12 — May 21, 2015

Meng-Han Tsai, MHA; Sudha Xirasagar, PhD, MBBS; Yi-Jhen Li, PhD; Piet C. de Groen, MD

Suggested citation for this article: Tsai M, Xirasagar S, Li Y, de Groen PC. Colonoscopy Screening Among US Adults Aged 40 or Older With a Family History of Colorectal Cancer. Prev Chronic Dis 2015;12:140533. DOI: http://dx.doi.org/10.5888/pcd12.140533.

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On this Page

• Abstract
• Introduction
• Methods
• Results
• Discussion
• Acknowledgments
• Author Information
• References
• Tables
• Appendix

Abstract

Introduction
Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines.

Methods
We studied colonoscopy screening rates among the US population reporting a CRC family history using 2005 and 2010 National Health Interview Survey data.

Results
Of 26,064 study-eligible respondents, 2,470 reported a CRC family history; of those with a family history, 45.6% had a colonoscopy (25.2% in 2005 and 65.8% 2010). The colonoscopy rate among first-degree relatives aged 40 to 49 in 2010 (38.3%) was about half that of first-degree relatives aged 50 or older (69.7%). First-degree relatives were nearly twice as likely as nonfirst-degree relatives to have a colonoscopy (adjusted odds ratio [AOR], 1.7; 95% confidence interval, 1.5–1.9), but those aged 40 to 49 were less likely to have a colonoscopy than those in older age groups (AOR, 2.6 for age 50–64; AOR, 3.6 for age ≥65). Interactions with age, insurance, and race/ethnicity were not significant. Having health insurance tripled the likelihood of screening.

Conclusion
Despite a 5-fold increase in colonoscopy screening rates since 2005, rates among first-degree relatives younger than the conventional screening age have lagged. Screening promotion targeted to this group may halt the recent rising trend of CRC among younger Americans.

Acknowledgments

This work was partly supported by funding from the National Cancer Institute under grant no. 1R15CA156098-01 (Sudha Xirasagar, principal investigator) and the Mayo Clinic.

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Author Information

Corresponding Author: Sudha Xirasagar, PhD, MBBS, Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health, 915 Greene St, Room 352, Columbia, SC 29208. Telephone: 803-576-6093. Email: sxirasagar@sc.edu.

Author Affiliations: Meng-Han Tsai, Yi-Jhen Li, University of South Carolina, Columbia, South Carolina; Piet C. de Groen, Mayo Clinic College of Medicine, Rochester, Minnesota.

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