How to Talk to Your Family About Screening


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As we enter the holiday season, we know that quality time spent connecting with family is upon us. Even if your gatherings are virtual this year, we encourage you to bring up your family medical history and support each other in understanding your family’s risk factors for colorectal cancer. Colorectal cancer is preventable if you know your risk and get screened at the right time; this conversation could save the life of someone you love, so why wait another year?

To help guide your conversation, take a look at the most up-to-date insights on access to effective screening methods and family history risk factors from the International Agency for Research on Cancer’s Colorectal Cancer Screening Handbook.

Know Your Family History and Risk-Factors

Knowing whether you are high risk vs. average risk for colorectal cancer, defined by whether or not you have a family or personal history of CRC or certain bowel diseases, is an important distinction to make. The first step to understanding your risk level starts with asking your family members if there has been any history of colorectal cancer history in your family tree. 

Along with certain medical conditions and environmental exposures, family history is a well-established risk-factor for developing CRC. In people with a first-degree relative with CRC, the risk is approximately double that of people with no such family history. The risk of CRC can then increase up to four-fold depending on the number of relatives affected, the presence of advanced adenomas, and their age at diagnosis. This increased risk means if a history of CRC is discovered in your family, you are recommended to get screened earlier, more often, and with more sensitive screening methods than a person without any history of CRC or other risk factors in their family. 

Access to the Right Screening for Your Risk Level

Talking with your doctor is the first step in the screening process, where your family history and other risk factors will be discussed in order to determine which screening method is right for you. And thanks to the Affordable Care Act, most insurance plans fully cover preventative cancer screening!

If you have a first-degree relative with a history of CRC or advanced adenoma diagnosed before age 60, you can expect your doctor to recommend screening by colonoscopy every five years starting at age 40, or 10 years before the age of diagnosis for the youngest affected relative, whichever is earlier. If you have a first-degree relative diagnosed with CRC or advanced adenoma after age 60, you may be offered less-invasive screening options.

Less-Invasive Screening Methods

While colonoscopies provide the opportunity to both find and prevent colorectal cancer, a less-invasive screening option that can be performed by the patient themselves, such as the Fecal Immunochemical Test (FIT), may be a better stepping stone for family members who are average risk.

Rolling with Resistance

Talking about serious health conditions such as colorectal cancer can be difficult for some family members, and you may encounter further resistance when you start motivating your relatives to get screened. Below are some common reasons people resist CRC screening, which can help you prepare to roll with that resistance instead of fighting it!

Lack of CRC awareness and of the purposes of CRC screening

 If you are taking charge and bringing the awareness to your family, then lack of awareness is no longer an acceptable excuse!

Perceived susceptibility to CRC; fear of dying from CRC

 CRC is one of the few cancers that is preventable if you get screened early enough, what could be more worth the trip to your doctor!?

Anxiety associated with repeated testing

 Peace of mind is knowing you are on top of your risks, which is better than worrying about “what if’s”

Lack of knowledge about screening effectiveness and procedures 

Share the resources you find here with your family members so they can see for themselves!

Negative perceptions about prevention and the relative weights of short-term inconveniences and long-term benefits. 

Inconveniences in life are unavoidable, but this one can save you life!  

Partner support

 Be there for your family members and support them! If you can, offer to drive them to the appointment or help shop for bowel prep supplies.

You will most likely encounter family members at different stages of readiness to make the decision to get screened. Even with the evidence of family history, you may have a brother or sister who just flat out refuses to get a colonoscopy. The guidelines around recommended screening methods are well-studied and exist to protect your health, but it’s important to remember- the best screening method is the one that gets done! Any screening is better than no screening, so do what you can to encourage those family members who aren’t ready for a colonoscopy yet to still get screened with a less-invasive method.

Next Steps and Additional Resources

Next step: start the conversation and keep it going! The process of nurturing support for your loved ones can take time. Be patient, be kind, and love one another! 

Curious to learn more about colorectal cancer screening? The Screening Mini Magazine will walk you through everything you need to know about screening- from understanding the importance of screening for cancer prevention to learning about the different types of tests available.

With tips from medical professionals, cancer survivors, and others who have been screened, this is a great resource for anyone on the fence about preventive screening or for anyone preparing for their screen!