Colorectal cancer risk assessment and screening recommendation: a community survey of healthcare providers' practice from a patient perspective

1592 persons aged 56-88 years randomly selected from the Hunter Community Study (HCS), New South Wales, Australia were mailed a questionnaire. 1117 participants (70%) returned a questionnaire.Thirty eight percent of respondents reported ever being asked about their family history of CRC. Ever discussing family history of CRC with a health care provider was significantly more likely to occur for persons with a higher level of education, who had ever received screening advice and with a lower physical component summary score. Fifty one percent of persons at "moderately/potentially high risk" were notified of their "increased risk" of developing CRC. Thirty one percent of persons across each level of risk had ever received CRC screening advice from a health care provider. Screening advice provision was significantly more likely to occur for persons who had ever discussed their family history of CRC with a health care provider and who were at "moderately/potentially high risk".Effective interventions that integrate both the assessment and notification of familial risk of CRC to the wider population are needed. Systematic and cost-effective mechanisms that facilitate family history collection, risk assessment and provision of screening advice within the primary health care setting are required.Worldwide, CRC comprises 9.4% of all cancer cases with one million diagnoses annually [1]. Survival from CRC is highly stage-dependent yet fewer than 40% of CRCs are diagnosed at a localised stage [2]. Screening is a cost-effective mechanism that reduces the incidence and mortality associated with CRC [3-5]. Population-based screening is recommended for those aged 50 years or older, with average-risk persons recommended to receive periodical Faecal Occult Blood Test (FOBT) screening or endoscopy screening, dependent on screening guidelines [6,7]. Several randomised controlled trials (RCTs) have indicated it is possible to reduce mortality from CRC mortality by 15% to 33% with Faeca