Tan Ker-Kan, Lim Tian-Zhi, Chan Dedrick Kok Hong, Chew Emily, Chow Wen-Min, Luo Nan, Wong Mee-Lian, Koh Gerald Choon-Huat
Division of Colorectal Surgery, University Surgical Cluster, National University Health System, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Int J Colorectal Dis. 2017 Jul;32(7):1065-1068. doi: 10.1007/s00384-017-2818-4. Epub 2017 Apr 13.
First degree relatives (FDR) of colorectal cancer (CRC) patients are at increased risk of CRC compared to the general population. However, screening colonoscopy rates amongst the FDRs remain dismal. The aim of the study was to explore the various issues amongst the patients and their FDR precluding their adoption of screening colonoscopy.
A qualitative study of CRC patients and their FDRs was performed. Semi-structured interviews were conducted with participants using open-ended questions until data saturation was achieved. These qualitative data were then thematically analysed.
Fifty CRC patients and thirty-one FDRs were recruited between June 2015 and December 2015. For the patients, three main themes emerged, which include (i) poor understanding of the CRC screening guidelines for their FDRs, (ii) recommendations are lacking amongst medical professionals and (iii) numerous barriers are hindering patients from being advocates for screening colonoscopy for their FDRs. For the FDRs, three main themes emerged. These include (i) poor understanding of the exact CRC screening guidelines amongst the FDRs, (ii) the lack of health promotion efforts amongst medical professionals and (iii) barriers to the uptake of screening colonoscopy such as fear of colonoscopy, high cost of the procedure, its associated inconvenience and perceived invulnerability of the individual.
Patients and FDRs are not aware of the increased risks of developing CRC amongst the family members. Guidelines regarding screening are also not clearly understood. The numerous barriers that are present amongst the CRC patients and their FDRs can be addressed.
与普通人群相比，结直肠癌（CRC）患者的一级亲属患结直肠癌的风险更高。然而，一级亲属中结肠镜筛查率仍然很低。本研究的目的是探讨患者及其一级亲属中阻碍他们接受结肠镜筛查的各种问题。
对结直肠癌患者及其一级亲属进行了定性研究。使用开放式问题对参与者进行半结构化访谈，直至达到数据饱和。然后对这些定性数据进行主题分析。
2015年6月至2015年12月期间招募了50名结直肠癌患者和31名一级亲属。对于患者来说，出现了三个主要主题，包括（i）对其一级亲属的结直肠癌筛查指南了解不足，（ii）医疗专业人员缺乏相关建议，（iii）众多障碍阻碍患者为其一级亲属倡导结肠镜筛查。对于一级亲属来说，也出现了三个主要主题。这些包括（i）一级亲属对确切的结直肠癌筛查指南了解不足，（ii）医疗专业人员缺乏健康促进措施，（iii）接受结肠镜筛查的障碍，如对结肠镜检查的恐惧、检查费用高、相关不便以及个人认为自己不易患病。
患者和一级亲属并未意识到家庭成员患结直肠癌的风险增加。关于筛查的指南也未得到清晰理解。结直肠癌患者及其一级亲属中存在的众多障碍是可以解决的。
