{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:22:27Z","timestamp":1740126147653,"version":"3.37.3"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,16]],"date-time":"2018-07-16T00:00:00Z","timestamp":1531699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Most people who are at increased familial colorectal cancer (<jats:styled-content style=\"fixed-case\">FCRC<\/jats:styled-content>) risk are not identified, despite the need for enhanced surveillance colonoscopy for effective <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> prevention. An online self\u2010test may enhance this identification. We assessed whether taking an online self\u2010test to identify increased <jats:styled-content style=\"fixed-case\">FCRC<\/jats:styled-content> risk increases anxiety, distress or <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> risk perception in population\u2010based <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>After the precolonoscopy consultation, patients who had a positive immunohistochemical occult faecal blood test (<jats:styled-content style=\"fixed-case\">iFOBT<\/jats:styled-content>+) in population\u2010based <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> screening were invited by email to take an online self\u2010test at home which returned details of family history. Anxiety (<jats:styled-content style=\"fixed-case\">STAI<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DY<\/jats:styled-content>), distress (<jats:styled-content style=\"fixed-case\">HADS<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> risk perception were assessed immediately before and after taking the online self\u2010test and 2 weeks later.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 250 participants invited, 177 (71%) completed the online self\u2010test and psychological questionnaires and 153 (61%) completed questionnaires 2 weeks later. The median age was 65 years (range 61\u201375). The <jats:styled-content style=\"fixed-case\">FCRC<\/jats:styled-content> risk was increased in 17 participants (9.6%). Of these, 12 (6.8%) had a highly increased <jats:styled-content style=\"fixed-case\">FCRC<\/jats:styled-content> risk and may benefit from germline genetic testing for Lynch syndrome. In 7 of 17 participants (40%) the self\u2010test obtained novel information on family history. Anxiety and distress levels were, and remained, below a clinically relevant level. Perception of <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> risk remained unchanged. Most participants (83%) would recommend the online self\u2010test to others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Of those with a <jats:styled-content style=\"fixed-case\">iFOBT<\/jats:styled-content>+, 9.6% had a previously unidentified increased<jats:styled-content style=\"fixed-case\">FCRC<\/jats:styled-content> risk and require an enhanced surveillance colonoscopy instead of <jats:styled-content style=\"fixed-case\">iFOBT<\/jats:styled-content>. As screening for this risk did not increase anxiety or distress, and was highly acceptable, we recommend adding the online self\u2010test to population\u2010based <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> screening.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14319","type":"journal-article","created":{"date-parts":[[2018,6,29]],"date-time":"2018-06-29T03:43:35Z","timestamp":1530243815000},"page":"897-904","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An online self\u2010test added to colorectal cancer screening can increase the effectiveness of familial cancer risk assessment without increasing distress"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0042-4888","authenticated-orcid":false,"given":"A.","family":"van Erkelens","sequence":"first","affiliation":[{"name":"Department of Human Genetics Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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