Awareness, barriers, and uptake of colorectal cancer screening among first-degree relatives: A cross-sectional study

Abstract

Background:
First-degree relatives (FDRs) of colorectal cancer (CRC) patients are at increased risk for CRC. Colonoscopy is the recommended screening modality, yet uptake in this high-risk group remains poorly characterized, particularly in Saudi Arabia.


Methods:
We conducted a cross-sectional study of FDR of patients diagnosed with CRC at a tertiary academic center. They completed a structured questionnaire assessing awareness of CRC screening, previous screening practice, and perceived barriers to undergoing a colonoscopy.


Results:

Among 346 FDRs, 122 (35.3%) were aware of CRC screening recommendations and 78 (22.5%) had undergone colonoscopy. Among participants who had not undergone colonoscopy and provided complete barrier-response data (
n
= 268), the most commonly reported barrier was lack of information or inadequate counseling (51.9%,
n
= 139), followed by psychological fear (17.9%,
n
= 48) and financial barriers (16.4%,
n
= 44). Colonoscopy uptake did not differ by gender (23.4% vs. 19.7%,
P
= 0.423) but was higher among those with higher educational attainment and medical backgrounds (
P
= 0.001).



Conclusion:
CRC screening awareness and colonoscopy uptake among FDRs of CRC patients are suboptimal. Family-centered counseling at diagnosis, structured patient navigation, and tailored education programs are needed to improve screening participation in this at-risk population.