Increasing Colonoscopy Screening in Relatives of Patients With Colorectal Cancer

colonoscopy, endoscope
Investigators assessed the effectiveness of using a tailored communication strategy for colonoscopy uptake in first-degree relatives of patients with colorectal cancer.

Colonoscopy uptake was higher in first-degree relatives of patients with colorectal cancer (CRC) after receiving tailored communication compared with relatives who received standard educational materials, according to a study published in Asia-Pacific Journal of Oncology Nursing.

Investigators conducted a single-blinded randomized controlled trial at a tertiary hospital and multiple community centers in Shenzhen, China, from March 2019 to September 2019. A total of 188 individuals were included in the analysis. Study participants met the following inclusion criteria:

  • aged 40 to 75 years or at least 10 years younger than their relative’s age at diagnosis
  • at least 1 first-degree relative with CRC younger than 60 years or 2 or more first-degree relatives with CRC of any age
  • no colonoscopy within the previous 5 years

Individuals who were randomly assigned to the intervention group received standard educational materials and additional tailored communication that included 2 written message sessions and 1 verbal message session. Individuals randomly assigned to the control group received standard educational materials. WeChat, a commonly used text and verbal communication platform in China, was used for all communications.

The primary outcome assessed whether or not participants had undergone a colonoscopy at 3 months postintervention. Secondary outcomes evaluated patient perceptions of CRC risk and severity as well as perceived barriers to and benefits of colonoscopy screening.

Participants who received tailored communication were significantly more likely to undergo colonoscopy compared with those in the control group (odds ratio, 2.752; 95% CI, 1.428-5.303; P <.01). Compared with patients who received standard educational materials, patients in the intervention group had a significant difference in perceived susceptibility of CRC, though the difference in perceived disease severity was not statistically significant. Perceived barriers in obtaining a colonoscopy were also lower in the intervention group.

Study limitations included a lack of generalizability to other populations or communication platforms. Additionally, only the short-term benefits of tailored communication were explored in the study.

“The finding[s] of this study further demonstrated that tailored health messages are promising in behavioral change areas, including cancer screening behavior,” the study authors noted. “Therefore, integrating tailored communication with the current practices in cancer screening promotion is suggested.”


Bai Y, Wong CL, Peng X, Choi KC, So WKW. Effectiveness of a tailored communication intervention on colonoscopy uptake for first degree relatives of colorectal cancer patients: a randomized controlled trial. Asia-Pac J Oncol. Published online April 20, 2022. doi:10.1016/j.apjon.2022.04.007