STUDY OBJECTIVE: The present study tested whether the surveillance behavior of women with a family history of colorectal cancer (CRC) differed from that of women without such a history. DESIGN: The study included 72,710 subjects from the population of E3N, a cohort study, part of the European Prospective Investigation on Cancer, investigating risk factors for cancer among women. RESULTS: Fecal occult-blood testing (FOBT) was reported by 19.4% of the women with no CRC in their family and by 21.8% of those with one or more CRC (frequency odds ratio (FOR) = 1.01; ns). The degree of kinship did not influence FOBT. Colonoscopy was reported by 10.9% of women with no CRC in their family; its frequency increased with increasing number of subjects affected by CRC in the family, in particular when it concerned first-degree relatives. Colonoscopy was reported almost four times more frequently by subjects having two or more first-degree relatives with CRC (FOR = 3.55; 95% CI 2.47-5.10) than by those without any affected member; the frequency of colonoscopy increased, though less sharply, among women with second-degree affected relatives, compared with those without any affected relative in their family. CONCLUSION: In conclusion, whereas FOBT was unaffected by family history of CRC, screening colonoscopy was more frequent among women with a reported family history and differed with the degree of kinship of the affected relatives. The high rate of colonoscopy observed among subjects with first- and second-degree relatives is likely due to physician participation in screening decisions.