A0175 - Patients With Advanced Colorectal Polyps Have Poor Knowledge of Colorectal Cancer Risk and Screening Recommendations for Their First-Degree Relatives

Abigail Braun, MD¹, Michelle Springer, MS, CGC¹, Timothy Yen, MD¹, Jeannine Espinoza, BA¹, Elizabeth Magnan, BA¹, Jordan Karlitz, MD², Swati Patel, MD, MS^1
1University of Colorado Anschutz Medical Center, Aurora, CO; ²University of Colorado Anschutz Medical Center, Denver, CO

Introduction: First-degree relatives (FDRs) of patients with advanced colorectal polyps (ACPs) are at increased risk of colorectal cancer (CRC) and warrant earlier colonoscopy screening than the general population. Appropriate screening is dependent on patient (proband) knowledge and communication of risk and recommendations with FDRs. The aim of this study was to assess probands’ knowledge of familial risk and need for increased screening in their FDRs, and to evaluate factors associated with accurate knowledge.

Methods: As part of an ongoing clinical trial, patients with ACPs (adenoma or serrated polyp ≥ 10 mm, villous features or high-grade dysplasia) diagnosed before the age of sixty were recruited from a statewide hospital system including eight hospital-based gastroenterology practices. Those who provided informed consent completed telephone surveys of demographic information, knowledge of familial risk and screening recommendations based on their polyp finding. Polyp characteristics were gathered from the medical record. Knowledge by baseline characteristics was compared using Chi Square Test.

Results: Of the 133 participants, median age at time of colonoscopy was 46, 53% were male, 89% White and 13% Latino/Hispanic. Most had an income > $45,000 (81%) and college/post-college education (68%). Most polyps were < 20 mm (67%), adenomatous (97%), without high-grade dysplasia (79%) and located in the left colon (52%) or rectum (24%). Only 47% (N=62) of participants were aware that FDRs are at increased risk of CRC based on their polyp, and 47% (N=63) were aware that FDRs are eligible for earlier colonoscopy screening. Women and non-Hispanic individuals had significantly better knowledge of family risk and screening recommendations (Table). Those with high-grade dysplasia were less likely to have accurate knowledge of familial risk. There was no significant difference in knowledge of risk or screening recommendations based on education, income, polyp size, location or presence of synchronous/metachronous advanced polyps.

Discussion: Less than half of participants with ACPs are aware that their family members are at increased risk of CRC and should get earlier colonoscopy screening. There is a critical need for colonoscopists to communicate familial risk and recommendations to those with advanced polyps . Future studies to understand why males and those of Hispanic or Latino ethnicity have sub-optimal knowledge can inform targeted educational campaigns.



Disclosures:


Abigail Braun, MD¹, Michelle Springer, MS, CGC¹, Timothy Yen, MD¹, Jeannine Espinoza, BA¹, Elizabeth Magnan, BA¹, Jordan Karlitz, MD², Swati Patel, MD, MS¹. A0175 - Patients With Advanced Colorectal Polyps Have Poor Knowledge of Colorectal Cancer Risk and Screening Recommendations for Their First-Degree Relatives, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.