Collection and Use of Cancer Family History in Primary Care

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services

Prepared by:
McMaster University Evidence-based Practice Center, Hamilton, ON
Task Order Leaders:
Nadeem Qureshi, M.B.B.S., D.M.
Brenda Wilson, M.B., Ch.B., M.Sc, M.R.C.P.(U.K.), F.F.P.H.

Authors:
Nadeem Qureshi, M.B.B.S., D.M.
Brenda Wilson, M.B., Ch.B., M.Sc., M.R.C.P.(U.K.), F.F.P.H.
Pasqualina Santaguida, B.Sc..P.T., Ph.D.
June Carroll, M.D., C.C.F.P., F.C.F.P.
Judith Allanson, M.B., Ch.B., F.R.C.P., F.R.C.P.(C.), F.C.C.M.G., D.A.B.M.G.
Carolina Ruiz Culebro, M.D.
Melissa Brouwers, Ph.D.
Parminder Raina, Ph.D.
AHRQ Publication No. 08-E001
October 2007

Suggested Citation:
Qureshi N, Wilson B, Santaguida P, Carroll J, Allanson J, Ruiz Culebro C, Brouwers M, Raina P. Collection and Use of Cancer Family History in Primary Care. Evidence Report/Technology Assessment No. 159 (prepared by the McMaster University Evidence-based Practice Center, under Contract No. 290-02-0020). AHRQ Publication No. 08-E001. Rockville, MD: Agency for Healthcare Research and Quality. October 2007.

This article/book was a systematic review of 56 English-only studies evaluating primary care practitioners' (PCP's) collection of family histories of breast, colorectal, ovarian, or prostate cancers in adults.

The review addressed three research questions: 1.) What is the evidence that patients know their family history of the four types of cancer cited above and report it accurately? 2.) How well do family history collection tools improve the acquisition of such information by PCP's? and 3.) What tools exist to help PCP's adequately evaluate and act upon family history-based risk factors and how well do any such tools perform?

This review was a thorough exploration of the above questions and developed numerous results and conclusions. These included the fact that respondents are more likely to accurately report relatives who are free of cancer (indicating specificity) than to report relatives who have had cancer (indicating sensitivity). Also, family history reporting may be more accurate for first degree relatives than second. In addition, accuracy could be influenced by the type of cancer involved and by the type of information collection method.

In the discussion of the recommendations of the authors, several points were noted. Among these were that a consensus should be reached regarding the extent of family history necessary for given clinical situations, the value of patient-completed tools in history collection and risk assessment, and that further research is necessary into the specifics of tool design, update interval, and the role of family history tools and risk assessment tools in the primary care setting.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1b.chapter.93702

In conclusion, this article is a useful examination of the strengths and weaknesses of family cancer history collection and data assessment tools and methods of interpretation in the primary care setting.