An Examination of the Psychosocial Factors Influencing Colorectal Cancer Patients' Communication of Colorectal Cancer Patient Risk with Their Siblings

Abstract

This study examined psychosocial factors influencing colorectal cancer (CRC) patients' communication with their first-degree relatives regarding their CRC risk. Among a sample of CRC patients who were members of a colon registry in New York (n = 127), 60% reported discussing CRC risk with their siblings. These discussions were related to the CRC patients' age of diagnosis, such that those diagnosed before age 45 years were more likely to communicate with their siblings about CRC risk. Despite advances made in CRC prevention, compliance with screening recommendations among individuals who may be at familial risk for the disease is low. Perhaps this underrepresentation reflects how CRC patients communicate with their first-degree relatives about their potential risk for the disease. This study examined the psychosocial factors influencing whether CRC patients communicate with their siblings about CRC risk. The sample included CRC patients with siblings who enrolled in a colon disease registry at a NYC metropolitan hospital. Participants completed questionnaires regarding their current psychosocial functioning, perceived risk of sibling's development of CRC, and communication of CRC risk with their siblings. Patients were predominantly Caucasian, with a mean age of 60.4 years. Of the 127 patients, 60% engaged in discussions with their siblings regarding their CRC risk. Patients diagnosed with CRC before the age of 45 years were more likely to discuss the risk of CRC with their siblings (P < 0.01). These data suggest that CRC patients may serve as an effective vehicle to promote CRC screening and support the need for health care providers to not only educate patients of the familial risk of CRC, but to also encourage these patients to communicate this information with their siblings. (Cancer Epidemiol

How is the increased risk of colorectal cancer in first-degree relatives of patients communicated?

“…We found that a higher percentage of CRC patients were informed of their FDRs' increased CRC risk (80.6%) than in other studies (33-77.6%) [3,5,8,[19][20][21][22][23] Several factors might have influenced the high rate of informed CRC patients in our study. First, the flow of information is better in young index patients with CRC and in conditions with strong family togetherness [3,24,25]. The mode of questionnaire distribution in our study implied strong togetherness within the affected families because the FDRs' consent had to be obtained by the CRC patients (selectional bias).…”

Family Ties: The Role of Family Context in Family Health History Communication About Cancer

“…To date, much of the literature on family history discussions about cancer have focused on patient-physician communication (Smith et al, 2011; Dickerson et al, 2012; Bell et al, 2015), communication among relatives of cancer survivors (Harris et al, 2010; Hay et al, 2009; Lawsin et al, 2009), and discussions surrounding genetic test results (Aktan-Collan et al, 2011; Bradbury et al, 2012; McCann, et al, 2009; Vos et al, 2011). Fewer studies have sought to identify family context or individual factors that may promote family health history discussions, yet this type of information could be used to identify families who may need support in having these conversations.…”

Life Events may Contribute to Family Communication About Cancer Risk Following BRCA1/2 Testing

“…These aspects, as well as the content and consequences of this family communication, would deserve to be explored further in other studies. Finally, although we did not assess this, life events, and particularly cancer-related life events, may also contribute to initiate discussions about cancer risk in families without a member tested for BRCA1/2 (Hay et al 2005;Hay et al 2008;Lawsin et al 2009;Pho et al 2000;Schroy et al 2005). Communication about cancer risk is, however, particularly relevant in families who are at high risk for cancer and, even more, when one of its members had the opportunity to receive detailed information about the impact of familial susceptibility through genetic counseling services.…”