Asking Patients With Colorectal Cancer to Help Get Their Siblings Screened Is Not That Helpful
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Asking Patients With Colorectal Cancer to Help Get Their Siblings Screened Is Not That Helpful

Douglas K. Rex, MD, MASGE, reviewing Choe L, et al. Gastrointest Endosc 2021 Dec 9.

We often tell our patients with colorectal cancer (CRC) or advanced adenomas that guidelines indicate their siblings are at increased risk of developing CRC or advanced adenomas; therefore, they should inform their siblings of this risk and encourage screening. In a randomized controlled trial from Singapore, 219 patients with CRC were randomly assigned to standard care or intervention. Patients in the standard care group were informed about guidelines and instructed to relay screening information to siblings. The intervention group members received standard care plus an envelope containing a CRC screening information sheet and a letter inviting siblings to contact the research team via email, telephone, text, etc. The intervention group participants also received weekly telephone reminders for 4 weeks, checking the status of sharing screening information with siblings. 

The self-reported rate of advocating to the siblings was 96.4% in the intervention group and 89.9% in the control group. The fraction of siblings who contacted the research team was 16.9% in the intervention group versus 11.1% in the control group (P<.05). The actual number who underwent screening is unknown. Sibling age of 60 years or older was an independent predictor of siblings not contacting the research team.

Douglas K. Rex, MD, FASGE

COMMENT

In many countries, including the U.S., it’s no longer legal for health care systems to contact relatives of patients with CRC or advanced adenomas because of privacy laws. These study findings suggest that asking patients with CRC to encourage screening among siblings is not very effective. It would seem that a recommendation by a primary care physician taking a family history from each patient is the most productive approach to increasing screening in patients at high risk for cancer or advanced adenomas.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Choe L, Lau J, Fong SY, et al. Colorectal cancer patients advocating screening to their siblings: a randomised behavioral intervention. Gastrointest Endosc 2021 Dec 9. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2021.11.042)

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