BackgroundFirst-degree relatives (FDRs) of probands with colorectal cancer (CRC) may be at increased risk of CRC and require colonoscopy. Proband disclosure about this risk and need for colonoscopy is essential for FDRs to take appropriate action. Low colonoscopy rates are reported among FDRs and little is known about the proband disclosure process. A better understanding of the barriers surrounding colonoscopy and disclosure is needed.MethodsCRC probands (n = 16) and FDRs (n = 9), recruited from a Canadian CRC Consortium, completed interviews to determine barriers to disclosure and colonoscopy, respectively. Interviews were analyzed using thematic analysis and participants’ motivation to disclose to FDRs or undertake colonoscopy was categorized into Stages of Change (i.e., Precontemplation, Contemplation, Preparation, Action, or Maintenance) using the transtheoretical model.Results25% of probands had not disclosed to any first-degree kin and were categorized in the Precontemplation or Contemplation Stage of Change. Barriers to disclosure included lack of information, negative expectations about familial reaction, assuming FDRs were aware of risk or already being screened, dysfunctional family dynamics, and cultural barriers. 75% of FDRs were categorized in the Precontemplation or Contemplation Stage of Change. Barriers included negative perceptions about colonoscopy, health-care provider related factors, practical concerns, and lack of information about CRC, risk, and colonoscopy.ConclusionsIn the absence of barriers such as cost and accessibility, this Canadian sample still reported several challenges to disclosure and colonoscopy adherence. Future research should explore interventions such as motivational interviewing to improve proband disclosure and to increase FDR adherence to colonoscopy.

中文翻译：

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检查结直肠癌风险状况与家庭成员的家族内交流和亲属对结肠镜检查的反应：一项定性研究

背景结直肠癌 (CRC) 先证者的一级亲属 (FDR) 患 CRC 的风险可能增加，需要进行结肠镜检查。先证者披露这种风险和结肠镜检查的必要性对于 FDR 采取适当行动至关重要。FDR 中报告的结肠镜检查率较低，并且对先证者披露过程知之甚少。需要更好地了解结肠镜检查和披露的障碍。方法 CRC 先证者 (n = 16) 和 FDR (n = 9)，从加拿大 CRC 联盟招募，分别完成了访谈以确定披露和结肠镜检查的障碍。使用主题分析对访谈进行分析，并将参与者向 FDR 披露或进行结肠镜检查的动机分为变化阶段（即预想、沉思、准备、行动、或维护）使用跨理论模型。结果 25% 的先证者没有向任何一级亲属透露，并被归类为预想或改变的沉思阶段。披露的障碍包括缺乏信息、对家庭反应的负面期望、假设 FDR 意识到风险或已经被筛选、功能失调的家庭动态和文化障碍。75% 的 FDR 被归类为预思考或变革的思考阶段。障碍包括对结肠镜检查、医疗保健提供者相关因素、实际问题的负面看法，以及缺乏关于 CRC、风险和结肠镜检查的信息。结论在没有成本和可及性等障碍的情况下，这个加拿大样本仍然报告了在披露和结肠镜检查依从性。