Consideration of family history of cancer in medical routine

Abstract

Family history of cancer (FHC) is important in the context of cancer prevention and risk counselling, but there is a lack of information about its consideration in medical routine. We aimed to characterize how FHC is assessed and taken into account in the primary care setting in Germany. We conducted a mail survey among 285 office-based physicians in south-west Germany. We sent a questionnaire to randomly selected general practitioners, dermatologists, gastroenterologists, gynaecologists, urologists and pulmonologists, asking about collection of information on FHC and implications for preventive counselling. A total of 207 physicians returned the questionnaire (response rate 73%), of whom 71% reported asking for FHC routinely, 17% reported using a standardized tool to collect the information and 35% reported regularly updating it. Implications of a positive FHC for counselling were heterogeneous, with priority on recommendations for screening. Referral to genetic counselling was considered by 34% of physicians, mainly gastroenterologists and gynaecologists. In the primary care setting in Germany, FHC is considered an important topic, but there is a lack of standardization in collecting the information and heterogeneity on the implications for counselling. Options to improve this situation, such as the implementation of standardized tools or centralized counselling systems, are needed.

The knowledge, attitudes and practices regarding family history of hereditary diseases amongst undergraduate students at the University of the Free State

“…breast, ovarian and colon cancer), heart disease, osteoporosis, asthma and depression. 1,4 If patients are familiar with their family medical history, especially regarding genetic or hereditary disorders, precautionary steps may be undertaken to minimise the damage of the disorder and to possibly prevent the onset of that disorder in oneself and in future generations. 3 Precautionary steps may include dietary and behavioural changes.…”

Awareness of family health history in a predominantly young adult population

“…Family health history (FHH) is a strong predictor of disease risk and useful for guiding preventive care, yet is persistently underutilized in clinical care. Barriers include patient’s limited knowledge about their FHH, the length of time it takes to collect a full FHH at the point of care, lack of awareness of the benefits of a FHH-based risk assessment, and the complexity of synthesizing the data into and actionable care plans [1–4]. In addition, Public understanding of the clinical significance of FHH varies [5, 6], and other factors such as family dynamics[7], culture[8], privacy[9], and openness about family members’ health impact completeness of the information patients share with their providers.…”

General practitioners’ (GPs) experience, attitudes and needs on clinical genetic services: a systematic review

“…Of the 62 final articles included, 36 studies were quantitative studies,27–62 13 were qualitative studies,3 63–74 9 were randomised controlled trials75–83 and 4 were mixed-methods study70 84–86 (online supplemental table 5). The selected studies were conducted in USA (n=20), UK (n=19), Canada (n=11), Australia (n=6), Asia (n=4), New Zealand (n=1) and South Africa (n=1).…”

“…Of which, Yu et al reported that 91% of the 409 GPs surveyed saw the importance to keep up with latest information on genetic disorders. Specifically, GPs expressed the need for more guidelines and timely updates on the use of genetic screening, genetic testing, genetic counselling and referrals 34 39 63 65 70. In addition, clearer guidance that is tailored to their practice and roles as GPs were also coveted 51 64 65 69.…”