Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London

Kohut, Kelly; D'Mello, Lucia; Bancroft, Elizabeth; Thomas, Sarah; Young, Mary‐Anne; Myhill, Kathryn; Shanley, Susan; Briggs, Brian H. J.; Newman, Michelle G.; Saraf, Ifthikhar M; Cox, Penny; Scambler, Sarah; Wagman, Lyndon; Wyndham, Michael T; Eeles, Rosalind; Ferris, Michelle

doi:10.1007/s10689-011-9482-6

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…For instance, Althius et.al showed that while being nullipar ER(+) increases the risk of breast cancer, ER (-) doesn't increase the risk. On the other hand, early menarche is more closely related with tumors ER(+)/PR(+) compared to those with tumors ER(-)/PR(-) (Althuis et al, 2004;Kohut et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Family History Attributes and Risk Factors for Breast Cancer in Turkey

Gokdemir-Yazar¹,

Yaprak²,

Colak³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: When dealing with breast cancer, early detection is closely associated with determining and closely monitoring high risk groups. The aim of this study was to determine the preventable risk factors that are specific for our country, and to understand which risk factors were most predominant. Materials and Methods: The study was planned as a case-control design. Women diagnosed with breast cancer who visited the Surgery, Obstetrics and Gynaecology, and Radiation Oncology outpatient clinics of the Izmir Dokuz Eylul University (DEU) School of Medicine were accepted as the case group. Then a control group matched for age was established among females who visited the outpatient clinics on the same days. A questionnaire prepared by the researchers was implemented using a face-to-face interview technique. The Mann-Whitney U test was used in the comparisons of the group averages, and the Pearson chi-square test in the comparisons between groups. In order to determine the dominant risk factors, binary logistical regression test was implemented. Results: A total of 138 patients, 69 cases and 69 controls, were included in the study. A significant difference can be detected between the groups in terms of BMI, smoking, breast cancer prevalence among first degree family members, presence of breast cancer among distant family members, existence of other types of cancers among family members and the age of onset of menopause (p<0.05). Logistical regression analysis revealed that the presence of breast cancer among first degree relatives increased the risk of developing breast cancer 5.7 times. Conclusions: Although some results of this study are compatible with findings in the literature, some are not. In order to determine unique risk factors, there is a clear need for large-scale studies.

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Section: Discussionmentioning

confidence: 99%

Family History Attributes and Risk Factors for Breast Cancer in Turkey

Gokdemir-Yazar¹,

Yaprak²,

Colak³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…A number of studies have demonstrated that response rates to mailed cancer family history questionnaires are low, typically around 50 % or less (Appleby-Tagoe et al 2012;Armel et al 2011;Kohut et al 2012;Mancuso et al 2004;Rahm et al 2007).…”

Section: Fhq Return Rates/ Genetic Counseling Attendance Ratesmentioning

confidence: 99%

All in the Family: Barriers and Motivators to the Use of Cancer Family History Questionnaires and the Impact on Attendance Rates

Armel

McCuaig

Gojska

et al. 2015

Journal of Genetic Counseling

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Data has demonstrated that family history questionnaires (FHQs) are an invaluable tool for assessing familial cancer risk and triaging patients for genetic counseling services. Despite their benefits, return rates of mailed FHQs from newly referred patients remain low, suggesting potential barriers to their use. To investigate this, a total of 461 participants, 239 who completed a FHQ (responders) and 222 who did not (non-responders), were surveyed at a subsequent appointment regarding potential barriers and motivators to using the FHQ. With respective rates of 51 and 56 %, there was no significant difference in the proportion of responders and non-responders who reported difficulty in completing the FHQ; however, for both groups factors related to family dynamics (large family size, lack of contact with relatives, and lack of knowledge of family history) were reported as major variables confounding completion of the FHQ. Responders were also significantly more likely to have a personal diagnosis of cancer (p = 0.02) and to report that their physician had discussed the reason for the appointment with them (p = 0.01). Overall, 19 % of non-responders returned their FHQ after being mailed an appointment letter and 67 % attended their scheduled genetic counseling appointment. These findings demonstrate that difficulty completing the FHQ is not inherent to its design but due to difficulty accessing one's family history, and that mailed appointment letters are a highly successful way to increase attendance rates in the non-responder population. Furthermore, these results demonstrate the important role that referring physicians play in the utilization of genetic counseling services.

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Analysis of patient reports on the referral process to two NSW cancer genetic services

Butel-Simoes

Spigelman

2014

Familial Cancer

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To evaluate trends and associations surrounding patient referral to cancer genetics services in NSW. The specific aims of the questionnaire used to collect information were to: (1) quantify the types of cancers being referred, (2) identify the source of referral for the patients, (3) categorise the referral as being either sought by the patient or suggested by the doctor, (4) quantify how often family history was asked, (5) determine who first raised the topic of family history, (6) identify any discouragement faced by patients, (7) clarify the cancer status of patients referred. A comparative patient-reported study was carried out using a questionnaire as the data collection tool in structured short interviews. The questions were aimed at eliciting the patient's understanding of why they were referred to the clinic, whether family history was discussed at the time of referral and who raised the issue via a series of YES/NO and open response questions. Data were collected from March 2012 to August 2012 from two different clinics, St Vincent's Hereditary Cancer Clinic, Sydney and the Hunter Family Cancer Service, Newcastle-both in New South Wales, Australia. Written consent was obtained. The study found that specialists were responsible for the majority of the 150 referrals and were more likely to be proactive in referring, as opposed to GPs (Phi and Cramer's V test). Patients reported that at the time of referral their family history was not asked in 13.5 % of cases, despite being significant. In the 131 cases where family history was discussed, it was the patient on approximately 2 in 5 occasions that brought up the topic. The most common types of cancer seen were breast cancer and colorectal. At both services GP referrals were more common then specialist referrals. On three occasions patients sought referral after being notified that the bloods they had collected by their GP for genetic testing were held by the laboratory due to failure to follow protocol. Six patients reported being discouraged to attend when seeking a referral. At the time of referral 58.7 % of patients were considered to be without cancer. Overall, 20 % of patients requested their referral to the cancer genetics clinics. The discussion of family history in the context of familial cancer is key to accurate risk assessment and management advice. Further education of doctors is required as evidenced by the number of patients where family history was not asked and in those patients who had bloods collected by their GP without counselling.

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Implications for cancer genetics practice of pro-actively assessing family history in a General Practice cohort in North West London

Cited by 5 publications

References 12 publications

Family History Attributes and Risk Factors for Breast Cancer in Turkey

Family History Attributes and Risk Factors for Breast Cancer in Turkey

All in the Family: Barriers and Motivators to the Use of Cancer Family History Questionnaires and the Impact on Attendance Rates

Analysis of patient reports on the referral process to two NSW cancer genetic services

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