STUDIES OF CANCER IN FAMILIES

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The Familial Cancer Program of the Vermont Cancer Center is a multidisciplinary clinical and research program that addresses the needs of patients and families with an excess risk for cancer. The program coordinates high-risk intervention, screening protocols, and research protocols that include collection of specimens from high risk patients and their family members for genetic studies. The focus of the program is diverse, including all known familial cancer syndromes, as well as families or individuals who may have apparent excess risk that does not fit a defined syndrome. During the period 12/1/95- 11/30/96 there were 82 new families referred to the program. The majority of the referrals have been from oncologists; among all referrals, triage review of cases revealed that approximately 25% were in the highest risk category meeting a known cancer familial syndrome. Data from these studies indicate that only one-third of all contacts result in follow-up to include genetic counseling or some other form of intervention. The two most common syndromes referred to the FCP are familial breast and ovarian cancer and hereditary nonpolyposis colon cancer, together making up approximately two-thirds of all referrals. Interestingly, only 10% of those individuals or families meeting established criteria for familial breast or colon cancer will actually follow through to the point of recieving genetic testing and counseling. In this research, the UVM GCRC has been used as the site of phlebotomy for a majority of cases. GCRC services allowed collection of the blood specimen and transfer to the Institution's Molecular Diagnostic Laboratory, where samples were prepared and referred to various research protocols for further analysis. It is anticipated that 100 new referrals will occur during the period 12/1/96-11/30/97. GCRC services have been critical to this research protocol by facilitating collection of blood specimens, as many patients have been reluctant to participate in this study if out-of-pocket costs associated with research specimen collection would be incurred.