Author Insights: Family Histories Should Be Updated to Better Identify Those Needing Intense Cancer Screening

Sharon E. Plon, MD, PhD, of the Baylor College of Medicine, and colleagues found updating family cancer histories is important to ensure that individuals at a higher risk of developing the disease who might benefit from more intense screening are identified. (Image: Sharon E. Plon, MD, PhD)

A family history that identifies members who have developed cancer is not a static entity but should be frequently updated, say researchers in an article appearing today in JAMA. Such updating can better identify individuals who might benefit from earlier or more intense screening, the authors said.

In a retrospective analysis, the researchers examined family histories taken when individuals were aged 30 years and again 20 years later and found the percentage of individuals who met criteria for more intense screening increased for colorectal, breast, and prostate cancer.

Regularly updating family history is important because a patient recounting a family history at, say, age 30 years may not have any close relative (such as a parent, grandparent, or sibling) with cancer at that point in time, but might have a close relative diagnosed with cancer within the next decade. In such cases, if the family history is not updated, the patient will not be identified as being at a higher risk. For example, having a close relative with colorectal cancer increases the risk of developing the disease 2- to 6-fold.

Sharon E. Plon, MD, PhD, senior author of the JAMA study and director of the Baylor College of Medicine Cancer Genetics Clinic in Houston discusses her team’s findings:

“We know already that physicians don’t do that good a job of taking family histories of cancer. And the other issue is how often should they repeat taking histories? They need to think about what has happened in their patients’ lives since the last time they saw them.

“Physicians face time pressures and need to ask patients a lot of questions about their health during an office visit. But they also need to take good family histories and update them every 5 to 10 years.

“One of the things that could make updating family histories easier might be electronic records, where patients could answer questions regularly online before an office visit. A computer program could then automatically identify changes in those histories and alert the physician to those changes.

“From the patient’s perspective, it’s important to know the age a relative was diagnosed with cancer and not necessarily when they died. They should also know [the site at which] the cancer started.”

Categories: Breast Cancer, Colon Cancer, Genetic Counseling/Testing/Therapy, Mammography, Prostate Cancer