Study objective. The present study tested whether the surveillance behavior
of women with a family history of colorectal cancer (CRC) differed from th
at of women without such a history.
Design. The study included 72,710 subjects from the population of E3N, a co
hort study, part of the European Prospective Investigation on Cancer, inves
tigating risk factors for cancer among women.
Results. Fecal occult-blood testing (FOBT) was reported by 19.4% of the wom
en with no CRC in their family and by 21.8% of those with one or more CRC (
frequency odds ratio (FOR) = 1.01; ns). The degree of kinship did not influ
ence FOBT. Colonoscopy was reported by 10.9% of women with no CRC in their
family; its frequency increased with increasing number of subjects affected
by CRC in the family, in particular when it concerned first-degree relativ
es. Colonoscopy was reported almost four times more frequently by subjects
having two or more first degree relatives with CRC (FOR = 3.55; 95%CI 2.47-
5.10) than by those without any affected member; the frequency of colonosco
py increased, though less sharply, among women with second-degree affected
relatives, compared with those without any affected relative in their famil
y.
Conclusion. In conclusion, whereas FOBT was unaffected by family history of
CRC, screening colonoscopy was more frequent among women with a reported f
amily history and differed with the degree of kinship of the affected relat
ives. The high rate of colonoscopy observed among subjects with first- and
second-degree relatives is likely due to physician participation in screeni
ng decisions. (C) 1999 American Health Foundation and Academic Press.