Only Close Family History Needed for Cancer Risk Assessment

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Oncology group releases new recommendations focused on two generations for determining genetic risk factors in new patientsTUESDAY, Feb. 4, 2014 (HealthDay News) -- Oncologists need to carefully document a new patient's family history of cancer to assess the genetic risk, but assessing close relatives is enough, new recommendations suggest.

Gathering information about cancer in first- and second-degree relatives will help identify patients with an increased hereditary risk to provide them with personalized short- and long-term management and treatment strategies, the American Society of Clinical Oncology said.

The new recommendations, published in the Journal of Clinical Oncology, are a change from the current standard of recording three generations of family history, according to a society news release.

"After reviewing the available evidence, [the organization] concluded that reported family history is most accurate in close relatives and loses accuracy in more distant relatives," according to the news release. "On the basis of this data, a history of cancer in first- and second-degree relatives is often sufficient."

First-degree relatives include parents, children and full siblings; second-degree relatives include grandparents, aunts and uncles, nieces and nephews, grandchildren and half-siblings. About 10 percent of all cancers are hereditary cancers, according to the news release.

"Genetic factors are a key component of precision medicine because they can unlock important information that can help an oncologist determine the best course of individualized treatment," society president Dr. Clifford Hudis said in the news release.

"An adequate family history is key to identifying those patients whose cancer may be associated with inherited genetic factors," he said.

The recommendations say the recording of a patient's family history should include the relative's type of primary cancer, their age at diagnosis, their ethnicity and whether the relative is on the patient's mother's or father's side of the family. Patients should also be asked about the results of any cancer genetic testing in any relative.

"Ongoing hereditary risk assessment is part of high-quality oncology care," Hudis said. "These recommendations provide clarity, guidance and support for the oncology professional and other specialists regarding what information to collect for a cancer family history and how to interpret it."

More information

The U.S. National Cancer Institute has more about cancer.

SOURCE: American Society of Clinical Oncology, news release, Feb. 3, 2014

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Sat Feb 08, 2014 01:39 AM

My mother had all the cancers that my sister and I have also had.  I always thought her cancers were due to poor living and eating habits.  Also alcoholism.  Of course her illnesses were prior to DNA testing to discover the deeper cause.  When my sister and I had genetic testing it was discovered to be Lynch Syndrome.  Her son and grandson also had the same genetic mutation.  It has come down to us through 4 generations that I know of.  My surgeon Matt Rawlins, did take a family history and based on that recomended genetic testing.  Now we know what to do to be proactive in treatment and that gives me peace of mind.   I have had great medical care and the miracle of being cancer free for now.  .   

Mon Feb 10, 2014 05:35 PM

I don't think these guidelines are personalized enough.

What if the person does not have siblings?  Are just the cancer histories of two people (the parents) enough?

What if a female patient does not have sisters?  Is just the mother's history enough?

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