D0169 - How Often Do We Provide Recommendations to Patients With Colorectal Cancer or Advanced Colonic Adenomas on When Their First-Degree Relatives Should Begin Colorectal Cancer Screening?

Introduction: First-degree relatives of patients found to have colorectal cancer (CRC) or advanced adenomas (AA) are advised to undergo colonoscopy starting at age 40, 10 years prior to time of CRC diagnosis in their first-degree relative, or at age of onset of AA in their first-degree relative; whichever comes first. Current guidelines recommend written communication to patients with CRC or AAs advising screening in first-degree relatives, which is particularly important in light of increased rates of early-onset CRC. We aimed to analyze the rate at which we provided guidance to patients found to have CRC or AAs on advising their first-degree relatives on timing of colonoscopy.

Methods: We analyzed patients at our institution who underwent outpatient colonoscopies from November 29, 2021 to April 30, 2022. AAs were defined as adenomas ≥ 1 centimeter (cm) in size with tubulovillous, villous, high-grade dysplasia or traditional serrated features on histology, or sessile serrated lesions (SSLs) either ≥ 1 cm or with dysplasia. Patients with prior history of CRC or AA were excluded. We assessed how often appropriate screening recommendations were provided to patients with CRC or AAs for first-degree relatives based on documentation within 3 months of colonoscopy.

Results: A total of 1332 colonoscopies were reviewed, with 47 patients meeting criteria for a new diagnosis of CRC or AA. Of these patients, 53.2% were African American and 57.4% were females (Table 1). The mean patient age was 56.9 years (± 10.6 years). Of these 47 patients, 3 patients (6.4%) were provided with specific written screening recommendations for first-degree relatives within 3 months of colonoscopy.

Discussion: In this retrospective analysis of patients found to have CRC or AAs on colonoscopy, only 6.4% were provided written guidance to advise first-degree relatives on appropriate timing for colonoscopy within three months after procedure. While verbal recommendations to patients may occur, patients may not recall specifics post-procedure or via telephone. Furthermore, guidelines call for recommendations for family members to be included in endoscopy reports, or through a letter meant to be shared with first-degree relatives. Considering these findings, we aim to provide an education intervention and templates for post-colonoscopy pathology letters and/or clinic visits to facilitate communication to patients with CRC or AAs on appropriately advising CRC screening in family members.