Background and Aims

Advanced colorectal polyps (adenoma or sessile serrated polyp ≥ 1 cm, adenoma with villous features, adenoma with high-grade dysplasia, or any sessile serrated polyps with dysplasia) are associated with an increased risk of future advanced colorectal neoplasia and confer an increased risk of advanced neoplasia to first-degree family members. Professional societies therefore recommend more intensive surveillance of these polyps and earlier screening for first-degree relatives. The aim of this study was to assess knowledge of personal and familial risk and recommendations among patients with advanced colorectal polyps and identify predictors of knowledge.

Methods

An online survey was designed to assess the domains of knowledge and risk perception regarding personal and familial colorectal cancer risk and screening recommendations. After expert review and pilot testing, the 37-item survey was electronically sent to all patients diagnosed with an advanced colon or rectal polyp under the age of 60. Patient report of polyp findings was compared to documented findings in the medical record. Univariable and multivariable regressions were performed to evaluate predictors of knowledge.

Results

One hundred thirty-seven out of 344 (39.8%) eligible patients responded to the survey. 28.5% of participants reported that the polyp they had removed was precancerous. 54.8% of participants reported that they have a higher risk of CRC, and 65.2% reported that they should be undergoing colonoscopy surveillance in 3 years or less. 40.1% reported that their first-degree family members are at increased CRC risk, and 38.0% reported that first-degree family members should get earlier screening. Participants reported their endoscopists as their top source of information about risk and recommendations, though only 7.3% of endoscopists made recommendations for family members. Female gender and higher income were predictors of accurate knowledge, as endoscopist was the main source of knowledge.

Conclusions

Patients with advanced colorectal polyps have poor knowledge of personal and familial CRC risk and recommendations. Endoscopists who remove advanced polyps are in an ideal position to educate their patients about their personal risk and the risk and recommendations for first-degree family members.

中文翻译：

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对与晚期结直肠息肉相关的个人和家庭结直肠癌风险和筛查建议知之甚少。

背景和目标

晚期结直肠息肉（腺瘤或无蒂锯齿状息肉 ≥ 1 cm、具有绒毛特征的腺瘤、伴有高度不典型增生的腺瘤或任何伴有不典型增生的无蒂锯齿状息肉）与未来晚期结直肠瘤形成的风险增加相关，并导致以下风险增加一级家庭成员的晚期肿瘤形成。因此，专业协会建议对这些息肉进行更密集的监测，并尽早筛查一级亲属。本研究的目的是评估晚期结直肠息肉患者的个人和家庭风险知识和建议，并确定知识的预测因子。

方法

一项在线调查旨在评估有关个人和家族结直肠癌风险和筛查建议的知识领域和风险认知。经过专家审查和试点测试，37 项调查以电子方式发送给所有 60 岁以下被诊断患有晚期结肠或直肠息肉的患者。将息肉发现的患者报告与医疗记录中记录的发现进行比较。进行单变量和多变量回归以评估知识的预测因子。

结果

344 名符合条件的患者中有 137 名 (39.8%) 对调查做出了回应。28.5% 的参与者报告他们切除的息肉是癌前病变。54.8% 的参与者报告他们患 CRC 的风险较高，65.2% 的参与者报告他们应该在 3 年或更短时间内接受结肠镜检查。40.1%的一级家庭成员结直肠癌风险增加，38.0%的一级家庭成员应尽早接受筛查。参与者报告说，他们的内镜医师是他们关于风险和建议的主要信息来源，尽管只有 7.3% 的内镜医师为家庭成员提出了建议。女性和较高的收入是准确知识的预测因素，因为内镜医师是知识的主要来源。

结论

晚期结直肠息肉患者对个人和家族性 CRC 风险和建议知之甚少。切除晚期息肉的内镜医师处于理想的位置，可以让患者了解他们的个人风险以及对一级家庭成员的风险和建议。