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An understanding of these risks, screening recommendations, and screening behaviors can inform strategies for reducing the CRC burden in these families. A comprehensive review of the literature published within the past 10 years has been performed to assess what is known about cancer risk, screening guidelines, adherence and barriers to screening, and effective interventions in persons with an FH of CRC and to identify FH tools used to identify these individuals and inform care. Existing data show that having 1 affected first\u2010degree relative (FDR) increases the CRC risk 2\u2010fold, and the risk increases with multiple affected FDRs and a younger age at diagnosis. There is variability in screening recommendations across consensus guidelines. Screening adherence is &lt;50% and is lower in persons under the age of 50 years. A provider's recommendation, multiple affected relatives, and family encouragement facilitate screening; insufficient collection of FH, low knowledge of guidelines, and poor family communication are important barriers. Effective interventions incorporate strategies for overcoming barriers, but these have not been broadly tested in clinical settings. Four strategies for reducing CRC in persons with familial risk are suggested: 1) improving the collection and utilization of the FH of cancer, 2) establishing a consensus for screening guidelines by FH, 3) enhancing provider\u2010patient knowledge of guidelines and communication about CRC risk, and 4) encouraging survivors to promote screening within their families and partnering with existing screening programs to expand their reach to high\u2010risk groups. <jats:bold><jats:italic>Cancer<\/jats:italic> 2016<\/jats:bold>. \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>. <jats:italic><jats:bold>Cancer 2016;122:2633\u20132645.<\/jats:bold> \u00a9 2016 American Cancer Society.<\/jats:italic><\/jats:p>","DOI":"10.1002\/cncr.30080","type":"journal-article","created":{"date-parts":[[2016,6,3]],"date-time":"2016-06-03T15:52:13Z","timestamp":1464969133000},"page":"2633-2645","source":"Crossref","is-referenced-by-count":167,"title":["Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state\u2010of\u2010the\u2010science review"],"prefix":"10.1002","volume":"122","author":[{"given":"Jan T.","family":"Lowery","sequence":"first","affiliation":[{"name":"Colorado School of Public Health Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis J.","family":"Ahnen","sequence":"additional","affiliation":[{"name":"School of Medicine and Gastroenterology of the Rockies University of Colorado Boulder Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Paul C.","family":"Schroy","sequence":"additional","affiliation":[{"name":"Department of Medicine Boston University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Hampel","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Center Ohio State University Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Baxter","sequence":"additional","affiliation":[{"name":"St. Michael's Hospital Newark New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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