Cancer risk assessment - Quality and impact of the family history interview
Cancer risk assessment - Quality and impact of the family history interview
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DOI：
10.1016/j.amepre.2004.05.003
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发表时间：
2004-10-01
影响因子：
5.5
通讯作者：
Syngal, S
中科院分区：
文献类型：
--
作者：
Murff, HJ;Byrne, D;Syngal, S
工作背景：识别结肠癌和乳腺癌高风险个体需要充分的家族史评估，并可能影响癌症筛查和基因检测的决定。存在很少的数据，评估的完整性，在primary care.Methods：回顾性图表审查995个新的患者访问28个初级保健医生评估的完整性，结肠癌或乳腺癌的家族癌症史。家族史信息进行了评估，包括诊断时的年龄，亲属关系的程度，和规格的疾病interests.Results：收集的679（68%）的患者的癌症诊断的家族史信息。关于受影响的个人和癌症诊断的具体信息存在于414（61%）的记录中。受影响的一级亲属比二级亲属更有可能记录他们的癌症诊断年龄（39%，95%置信区间[CI] = 34%-44% vs 16%，95% CI=12%-20%）。51%的结肠癌、-18%的乳腺癌和27%的卵巢癌患者的一级亲属诊断出癌症时的年龄。只有17%的人谁符合标准的早发性乳腺癌基因检测转介genetic service.Conclusions：充分的癌症风险评估，使用家族史信息，需要在癌症诊断和癌症诊断的规格的年龄。诊断时的年龄经常在家族史评估中缺失，这可能对高风险个体的识别产生潜在影响。当家族史信息确实确定了高风险个体时，只有少数人被转介接受遗传服务。(C)2004年美国预防医学杂志。
Background: Identification of individuals at high risk for colon and breast cancer requires an adequate family history assessment and can influence cancer screening and genetic testing decisions. Little data exist that evaluate the completeness of the family history interview in primary care.Methods: Retrospective chart review of 995 new patient visits to 28 primary care physicians evaluating the completeness of the family cancer history for colon or breast cancer. Family history information was evaluated for inclusion of age at diagnosis, degree of kinship, and specification of disease of interest.Results: Family history information on cancer diagnoses was collected on 679 (68%) of the patients. Specific information regarding the individual affected and the cancer diagnosis was present in 414 (61%) of the records. Affected first-degree relatives were more likely to have their age of cancer diagnosis recorded than second-degree relatives (39%, 95% confidence interval [CI] = 34%-44% vs 16%, 95% CI=12%-20%). Age at diagnosis of cancer in first-degree relatives was documented in 51% of colon cancers, -18% of breast cancers, and 27% of ovarian cancers. Only 17% of individuals who meet criteria for early-onset breast cancer genetic testing were referred for genetic services.Conclusions: Adequate cancer risk assessment using family history information requires age at cancer diagnosis and specification of a cancer diagnosis. Age at diagnosis was frequently missing from family history assessments, which could have a potential impact on identification of high-risk individuals. When family history information does identify high-risk individuals, only the minority are referred for genetic services. (C) 2004 American Journal of Preventive Medicine.