Your Cancer Family Tree

Cancer screenings guidelines affected by family history

(RxWiki News) As with all of medicine these days, researchers are now finding that cancer screenings need to be personalized. Your screening schedules should be based on your family history.

A family history of cancer, particularly among close relatives, is one of the most important predictors of an individual's risk of developing the disease. If and when someone in your family gets cancer, you need to let your healthcare provider know, as this may alter when and how often you should be screened for that cancer.

"Keep your doctors up-to-date with your family cancer history."

To examine how a person's family history of cancer impacts risk, a multi-center team looked at the National Cancer Institute-funded Cancer Genetics Network (CGN), a registry of thousands of individuals with a personal or family history of cancer.

Researchers analyzed detailed family history information of more than 11,000 CGN participants. These histories were updated annually over an average of eight years.

Colorectal, breast and prostate cancer were the focus of this study since established guidelines for these common tumors can be affected by family history.

Analyzing overall family history information, between ages 30 and 50, the percentage of participants whose risk of colorectal cancer increased enough to affect screening recommendations more than tripled.

Likewise, the percentage of women in that age group with a change in breast cancer risk that would call for breast MRI increased almost 60 percent.

A smaller, yet still significant increase in prostate cancer risk was seen in men in this age group, as well.

Under current guidelines, for example, a 42-year-old woman with no family history of colorectal cancer would have her first colonoscopy at age 50 and repeat the exam every 10 years.

But say her 46-year-old brother is diagnosed with that cancer, the guidelines recommend that she have an immediate colonoscopy that should be repeated every 5 years.

Similarly, women with a family history of breast cancer may need to add MRIs to their routine mammograms.

Authors of the study published in the Journal of the American Medical Association (JAMA) note that primary care physicians should make a practice of updating family cancer histories every five years, particularly among patients between the ages of 30 and 50.

Sharon Plon, MD, PhD, professor of Pediatrics and of Molecular and Human Genetics at Baylor College of Medicine and senior author of the JAMA report, says she hopes the findings encourage physicians to ask more questions. She adds that with the increasing use of electronic medical records, this data could prove crucial in ensuring that patients are screened at the earliest possible time.

Patients should also alert their doctors of changes in family history, including the type of cancer and the age of onset, says corresponding author, Dianne Finkelstein, Ph.D., professor of Medicine at Harvard Medical School.

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Review Date: 
July 12, 2011