Background: The association between family history of colorectal cancer (CRC) in first degree relatives (FDRs) and the risk of developing the disease has been well established. However, little is known about the degree of awareness of CRC risk factors amongst FDRs. This study examined awareness of familial, dietary and lifestyle risk amongst FDRs.

Method: Consent to approach relatives was obtained from CRC patients who attended outpatients following surgery for CRC. A study specific questionnaire was sent by post to their FDRs. The dietary and lifestyle risk factors tested in the questionnaire were those promoted in CRC educational material.

Results: One hundred and four questionnaires were returned out of 137 sent (76%). Fifty-nine per cent (n = 61) of FDRs were aware of their increased risk. Fifty-five per cent (n = 57) were aware of the link between CRC and smoking; however, knowledge of association of CRC with excessive alcohol consumption (32%) and lack of exercise (40%) was less well appreciated. Higher awareness scores were obtained by those with a university education (P < 0.001). Ninety four per cent believed that relatives of CRC patients were not provided with enough information as to their being at risk and risk factors.

Conclusions: This study provides an initial assessment of the awareness of CRC risk factors in a population at increased risk. It demonstrates a poor level of knowledge. Improved education strategies allowing FDRs to make dietary and lifestyle modifications that could reduce their lifetime risk of developing CRC are necessary.