American Society of Clinical Oncology Expert Statement: Collection and Use of a Cancer Family History for Oncology Providers

Clinically relevant lessons from Family HealthLink: a cancer and coronary heart disease familial risk assessment tool

“…31 Additional studies have demonstrated the need for family history collection and clear referral guidelines for oncology professionals and primary-care providers alike. 4,20,32 Third, we found incomplete coronary heart disease family history documentation (130 of 199; 65.3%) and referral by the oncology providers. In total, only 13.4% of those in cohort 2 with high-risk coronary heart disease classifications were referred; of these, only one had electronic medical record documentation of coronary heart disease family history as the reason.…”

“…19,20,36 This is especially true for busy primarycare practices because a number of studies have shown that, on average, less than 10 minutes is spent collecting family history information for the purpose of patient assessment. 37,38 Automated triage tools such as Family HealthLink also have the capacity to self-populate electronic medical records and, as such, directly affect clinical decision support.…”

“…[12][13][14][15] Identification of individuals at increased risk allows for presymptomatic screening and disease detection, as well as appropriate referral for genetic counseling and testing. 4,5 Despite growing evidence regarding the importance and efficacy of using family history, and the need for health-care providers to have family history triage tools for personalized health-care delivery, [16][17][18][19][20] this type of approach has not been broadly applied in clinical practice. By tailoring personalized risk messages, interactive online family health history tools also have the potential to be highly effective in the context of the behavioral intention of the individual user.…”

The History and Physical in Cancer Care: A Primer for the Oncology Advanced Practitioner

“…In a traditional medical history, the focus is on risk and determination of likely disease. In cancer care the family history of cancer needs to be explored at great length (Lu et al, 2014). Primary (mother, father, and siblings) and secondary (cousins, aunts, uncles, and grandparents) histories of family cancer diagnosis must be established.…”

“…If there is a family history of cancer noted, the AP should determine the age at diagnosis, the course of the illness, and the patient's reaction to the illness. This is done not only to determine a patient's cancer risk but also as an indication for further genetic evaluation in order to determine future patient and/or family risk (Lu et al, 2014). The other illnesses or causes of death that are present in the patient's family history should be noted, as in the traditional medical history, but this is not usually critical information for the cancer care provider.…”