[结直肠癌患者一级亲属筛查不足及对危险因素的认知度低]

Vítek P, Kajzrlíková I M, Bures J, Chalupa J

Lékarská fakulta Ostravské Univerzity v Ostrave.

Vnitr Lek. 2011 Dec;57(12):1057-61.

INTRODUCTION

First-degree relatives ofcolorectal cancer patients have higher risk of disease, thus colonoscopic screening should be started at the age of 40 in this group. Goal of the study was to assess their awareness of the colorectal cancer risk factors and their compliance with colorectal cancer screening programme.

METHODS

62 patients after colorectal cancer resection and their 67 first-degree relatives (42% out of 160 addressed) answered structured questionnaire and counselling focused on colorectal cancer risk factors, and screening participation.

RESULTS

Before diagnosis of colorectal cancer only 18% of colorectal cancer patients (11/62) were aware of its risk factors, after diagnosis their awareness increased to 65% (40/62, p < 0.001). Before questionnaire 46% of first-degree relatives (31/67) were aware of colorectal cancer risk factors, after counselling awareness increased to 66% (44/67, p = 0.024). 79% (53/67) offirst-degree relatives were aware of their increased familial risk. 28% (19/67) of first-degree relatives enrolled for colorectal cancer screening. Most frequent screening method was fecal occult blood test (FOBT) in 21% (14/67) of first-degree relatives, colonoscopy was performed only in 7% (8/67) of first-degree relatives. Average age of screening participation was 53 years. 22% (15/67) of first-degree relatives refused any screening in the future.

CONCLUSIONS

We have found low awareness of colorectal cancer risk factors in colorectal cancer patients and their relatives before their diagnosis of disease respectively before their counselling. First-degree relatives are aware of their increased risk, however their screening participation is unsatisfactory. Screening is performed only in minority of first-degree relatives, often late and with inappropriate modality (FOBT). 22% of first-degree relatives refused any screening in spite of their increased colorectal cancer risk.

引言

结直肠癌患者的一级亲属患该病的风险更高，因此该群体应在40岁开始进行结肠镜筛查。本研究的目的是评估他们对结直肠癌危险因素的认识以及他们对结直肠癌筛查计划的依从性。

方法

62例结直肠癌切除术后患者及其67名一级亲属（占所联系的160人的42%）回答了关于结直肠癌危险因素和筛查参与情况的结构化问卷并接受了咨询。

结果

在结直肠癌诊断之前，只有18%的结直肠癌患者（11/62）知晓其危险因素，诊断之后，这一比例增至65%（40/62，p<0.001）。在问卷调查之前，46%的一级亲属（31/67）知晓结直肠癌危险因素，咨询之后，知晓率增至66%（44/67，p=0.024）。79%（53/67）的一级亲属知晓其家族患病风险增加。28%（19/67）的一级亲属登记参加结直肠癌筛查。最常用的筛查方法是粪便潜血试验（FOBT），21%（14/67）的一级亲属采用该方法，只有7%（8/67）的一级亲属接受了结肠镜检查。筛查参与的平均年龄为53岁。22%（15/67）的一级亲属拒绝未来的任何筛查。