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To describe screening colonoscopy use in those with a family history of colorectal cancer (CRC).Colonoscopy is an effective means of screening for CRC and is preferred for individuals at higher risk. We therefore derived population-based estimates of colonoscopy use and analyzed how individual characteristics and family history correlate with colonoscopy.Individuals between the ages of 41 and 75 years who responded to the Cancer Control Module of the 2000 National Health Interview Study were analyzed. Screening colonoscopy was defined as having a colonoscopy for screening purposes within the last 10 years. Screening colonoscopy was the dependent variable and family history was the independent variable in a logistic regression model that included self-described sociodemographic characteristics.Of the 13,160 individuals in the analysis, 6.8% had a family history of CRC, corresponding to approximately 5.5 million individuals in the United States. Those with a family history were significantly more likely to report screening colonoscopy (27.8%) than those without a family history (7.7%; P<0.001). In those with a family history, screening colonoscopy significantly correlated with tobacco use, education, and age. There was no trend for increased screening colonoscopy with having multiple family members or a young family member with CRC.Over 5.5 million people in the US have a family history of CRC, and only 1 in 4 report having had a screening colonoscopy by the year 2000. Improving knowledge about CRC and addressing other barriers to screening in this group will be important components of improving screening colonoscopy utilization.