• Robert H Fletcher, Rebecca Lobb, Mark R Bauer, James Alan Kemp, Richard C Palmer, Ken P Kleinman, Irina Miroshnik, and Karen M Emmons.
• Department of Ambulatory Care and Prevention, Harvard Medical School, Harvard Pilgrim Health Care, and Harvard Vanguard Medical Associates, Boston, MA, USA. Robert_Fletcher@hms.harvard.edu
• J Gen Intern Med. 2007 Apr 1; 22 (4): 508513508-13.

ObjectivesTo compare screening practices and beliefs in patients with and without a clinically important family history.DesignWe mailed a brief questionnaire asking about family history and a second, longer survey asking about knowledge of and beliefs about colorectal cancer to all respondents with a family history and a random sample of respondents without a family history of colorectal cancer. We reviewed electronic medical records for screening examinations and recording of family history.ParticipantsOne thousand eight hundred seventy of 6,807 randomly selected patients ages 35-55 years who had been continuously enrolled in a large multispecialty group practice for at least 5 years.MeasurementsRecognition of increased risk, screening practices, and beliefs-all according to strength of family history and patient's age.ResultsNineteen percent of respondents reported a family history of colorectal cancer. In 11%, this history was strong enough to warrant screening before age 50 years. However, only 39% (95% CI 36, 42) of respondents under the age of 50 years said they had been asked about family history and only 45% of those with a strong family history of colorectal cancer had been screened appropriately. Forty-six percent of patients with a strong family history did not know that they should be screened at a younger age than average risk people. Medical records mentioned family history of colorectal cancer in 59% of patients reporting a family history.ConclusionsMore efforts are needed to translate information about family history of colorectal cancer into the care of patients.

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