Poor patient knowledge regarding family history of colon polyps: implications for the feasibility of stratified screening recommendations

• Published in: Gastrointestinal endoscopy 2012-03, Vol.75 (3), p.598-603
• Main Authors: Elias, Pooja Sukhwani, MD, Romagnuolo, Joseph, MD, MSc, Hoffman, Brenda, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cohort Studies; Colonic Polyps - diagnosis; Colonic Polyps - genetics; Colonoscopy; Digestive system. Abdomen; Endoscopy; Family Health; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Health Knowledge, Attitudes, Practice; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Pilot Projects; Retrospective Studies; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2011.10.001

Background In 2008, the American College of Gastroenterology (ACG) modified its colorectal screening guidelines regarding patients with family histories of colorectal polyps, specifically highlighting the importance of obtaining detailed history that includes the number, type, and size of adenomas found in a patient's relative. This information is then used to guide screening recommendations for these patients. Objective To assess the proportion of patients undergoing screening colonscopy for a family history of polyps who have knowledge of their family members' colonoscopy findings. Design Retrospective, single-center cohort pilot study. Setting Tertiary care medical center. Patients Patients who presented for screening colonoscopy between 2008 and 2010 with an indication of family history of polyps. Interventions Obtain detailed history regarding patient's family history of polyps, including which family member, age of family member at diagnosis, size, type and number of polyps found. Main Outcome Measurements Knowledge of family history. Results Seventy-three patients were included in the study. Their knowledge of their family histories of polyps showed the following: 23.2% (17/73; 95% CI, 14%-35%) did not know which family member had polyps, 42.5% (31/73; 95% CI, 31%-55%) did not know the age at diagnosis, 71.2% (52/73; 95% CI, 59%-81%) did not know the polyp type, 90.4% (66/73; 95% CI, 81%-96%) did not know the number of polyps found, and 97.3% (71/73; 95% CI, 90%-100%) did not know the polyp size. Limitations Retrospective study at a single tertiary referral center. Conclusions Patients' knowledge regarding the details of their family histories of polyp data appears often unknown or incomplete. Thus, at present, it may not appear feasible or practical to incorporate this level of information in colon cancer screening guidelines.