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Cancer risk awareness and screening uptake in individuals at higher risk for colon cancer: a cross-sectional study
  1. Hamideh Salimzadeh1,
  2. Faraz Bishehsari2,
  3. Alireza Delavari1,
  4. Gilda Barzin1,
  5. Mohammad Amani1,
  6. Azam Majidi1,
  7. Alireza Sadjadi1,
  8. Reza Malekzadeh1
  1. 1Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  2. 2Division of Gastroenterology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Hamideh Salimzadeh; hsalimzadeh{at}


Objective We aimed to measure cancer knowledge and feasibility of a screening colonoscopy among a cohort of individuals at higher risk of colon cancer.

Methods This study was conducted as part of an ongoing screening cohort, in which first degree relatives (FDRs) of patients with colon cancer are invited to participate in a free of charge screening colonoscopy. We enrolled 1017 FDRs in the study between 2013 and 2014 measuring their data on demographics, cancer knowledge and colonoscopy uptake. A p value of <0.05 was considered statistically significant.

Results The relative's mean age was 48.7 years. Only about 28% of FDRs were aware of their increased risk for cancer, near 35.0% had ever heard about colonoscopy with 22% aware of the correct age to start screening. Comparing cancer knowledge of FDRs at high risk versus those at moderate risk, we recorded non-significant differences (p>0.05). Almost two-thirds of FDRs expressed willingness to undergo a colonoscopy and 49.2% completed the procedure, of which 12.8% had advanced neoplasm.

Conclusions Our data indicated that remarkable numbers of FDRs were not still informed of their cancer risk or never received a physician recommendation for screening. The desirable uptake at first invitation, which would be higher over successive invitations, supports the feasibility of a family-based recruitment approach for early screening. This has promising implications to introduce targeted screening colonoscopy into the healthcare system in Iran and other developing nations.

  • Family cancer
  • compliance
  • colonoscopy
  • awareness
  • colorectal cancer screening

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors HS analysed the data and drafted the manuscript. FB, AD, MA and RM provided clinical advice. GB collected data. AM and AS were involved in the study design and interpretation of data. All authors read the manuscript and approved the final version.

  • Funding Tehran University of Medical Sciences and Health Services (91033718830).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Ethics Committee of the Digestive Diseases Research Institute, Tehran University of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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