Colonoscopy Participation Rate and its Determinants among First-Degree Relatives of Colorectal Cancer Patients: A Cross-sectional Study

Abstract Introduction: Colorectal cancer (CRC) is a significant global health concern. First-degree relatives (FDR) of colorectal cancer patients are at higher risk of developing the disease, emphasizing the importance of screening by colonoscopy. Screening behavior can be influenced by healthcare system-related and psychological factors. There is a scarcity of studies related to this in India. Objectives: We aimed to assess the participation rate in colonoscopy and its determinants among first-degree relatives of colorectal cancer patients. Materials and Methods: A cross-sectional study was conducted among 60 first-degree relatives of colorectal cancer patients in a tertiary care center in Kerala from February to August 2023 using a pre-validated questionnaire based on the health belief model (HBM). An interview was conducted, and data were analyzed using SPSS version 25. Results: Of the 60 first-degree relatives assessed, only 8% had undergone colorectal cancer screening by colonoscopy. Mean age at diagnosis of CRC in the index patient was 62 ± 8 years, while the mean age of FDRs at diagnosis was 45.53 ± 10.1 years. HBM variables, namely, perceived susceptibility, perceived benefits, and cues to action, were observed to have a statistically significant association with the uptake of the colonoscopy screening procedure. “Fear of the screening procedure” (38%) was the most frequently observed barrier for undergoing colonoscopy screening. Conclusion: Knowledge about the facilitators and barriers to screening behavior among first-degree relatives will help healthcare providers tackle the low screening rates and reduce the burden of colorectal cancer in these vulnerable populations.