Does a screening questionnaire for familial and hereditary colorectal cancer risk work in a health insurance population?

The aim of our study was to evaluate actual prevalence, uptake and first experiences with a questionnaire developed for early detection of colorectal cancer (CRC) in persons with familial/hereditary risk. A cross sectional study in an insurance population aged 30-54 years was conducted. Subjects with ICD-10 codes C00 to C97 and D37 to D48 were excluded. A standardised questionnaire was sent to 12,139 subjects. Three months later, subjects with a reported family history were followed by a second questionnaire. An additional telephone survey was performed to validate responses. Nineteen per cent met the inclusion criteria (mean age 45 ± 7 years, 38% men). Three hundred and seventy-three subjects (16%) were followed by a second questionnaire. Of these, 248 (66%) returned. Forty-four per cent were already aware of their increased risk of developing CRC. Awareness was associated with knowledge of CRC. One hundred subjects (41%) reported that they had informed their general practitioner (GP) or gastroenterologist. A colonoscopy or stool test was recommended to 92. Subjects who found out about their increased risk for the first time, reported significantly less frequent physician contact (GP: 20% vs. 34%, gastroenterologist: 8% vs. 21%). Results indicate that there is a need for a structured, person at risk-adapted, statutory early detection program.