Exploring Colorectal Cancer Diagnosis Disclosure to First-degree Relatives: An African American Family Case Series

Objective: Compliance with colorectal cancer (CRC) screening recommendations requires people to know if a first-degree relative (FDR) has been diagnosed with colorectal cancer. This study explored the disclosure process among African American CRC survivors and the impact of the disclosure on the screening behaviors of the FDRs with whom they shared their diagnosis. Methodology: CRC survivors were recruited from two cancer centers in Florida. This two-phase study employed a double qualitative research approach including: 1) an in-depth, face-to-face semi-structured, interview with CRC patients in phase one and 2) a semi-structured telephone interviews with FDRs in the second phase. Results/Impact: Findings from this study have the potential to: 1) advance the lack of knowledge about the dynamics of CRC disclosure to FDRs in African Americans, 2) identify appropriate provider recommendations for disease disclosure and communication of familial risk to FDRs, 3) inform the development of culturally relevant interventions related to CRC screening, 4) introduce the innovative use of the family secrets framework into public health research, and 5) ultimately narrow the CRC health disparity among African Americans, especially those with familial risk. Conclusion: Understanding the positive and negative impacts of CRC diagnosis disclosure among African Americans will contribute to the identification of appropriate recommendations for disease disclosure to a first-degree relative. Additionally, an increased understanding of the criteria one uses to make a decision about CRC disclosure will contribute to the development of culturally relevant interventions that contribute to narrowing the CRC health disparity among African Americans.