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Background: This study investigated whether receiving the results of predictive genetic testing for Lynch syndrome, indicating the presence or absence of an inherited predisposition to various cancers, including colorectal cancer, was associated with change in individual colonoscopy and smoking behaviors, which could prevent colorectal cancer., Methods: The study population included individuals with no previous diagnosis of colorectal cancer, whose families had already identified deleterious mutations in the mismatch repair or EPCAM genes. Hypotheses were generated from a simple health economics model and tested against individual-level panel data from the Australasian Colorectal Cancer Family Registry., Results: The empirical analysis revealed evidence consistent with some of the hypotheses, with a higher likelihood of undergoing colonoscopy in those who discovered their genetic predisposition to colorectal cancer and a lower likelihood of quitting smoking in those who discovered their lack thereof., Conclusions: Predictive genetic information about Lynch syndrome was associated with change in individual colonoscopy and smoking behaviors but not necessarily in ways to improve population health., Impact: The study findings suggest that the impact of personalized medicine on disease prevention is intricate, warranting further analyses to determine the net benefits and costs. Cancer Epidemiol Biomarkers Prev; 25(11); 1524-33. ©2016 AACR., Competing Interests: The authors declare no conflict of interest., (©2016 American Association for Cancer Research.)

Context: People with a family history of colorectal cancer (CRC) are at increased risk of developing the disease. Information on the screening practices of this segment of the population is scarce., Evidence Acquisition: A systematic review was conducted of observational studies to identify factors associated with CRC screening participation for people at increased risk due to family history of the disease.MEDLINE, Cinahl Information Sevices, Embase, and PsycINFO databases were searched comprehensively between January 1995 and May 2012 to identify relevant articles. To be included, studies had to report on screening for people who had at least one first-degree relative with CRC, have described the study design, and reported on at least two predictors of adherence to CRC screening using a multivariate analysis., Evidence Synthesis: The search identified a total of 4986 articles, of which ten met the review's inclusion criteria. There were important inconsistencies among studies in the factors that were associated with screening. Receiving recommendations from clinicians was the most consistent predictor identified across studies. The review also revealed a consistent pattern of association with predictors related to familial aspects of CRC, such as strength of family history, and relationship to the affected relative. Among the psychological constructs, "social influence" emerged as the most consistent predictor of screening participation., Conclusions: This review provides evidence that clinicians, as well as use of family history and social networks, offer the most promising avenues to promoting and improving screening participation by individuals at increased risk of colorectal cancer., (Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)