Familial Cancer

, Volume 12, Issue 3, pp 497–502 | Cite as

Cancer family history triage: a key step in the decision to offer screening and genetic testing

Original Article


The Macmillan Cancer Family History Service in Teesside has provided genetic risk assessment for individuals with a personal or family history of cancer since 2004. We sought to examine the effect of risk assessment on patient management, with particular emphasis on referral for clinical screening and selection of families for tertiary genetics assessment. The degree of concordance between the initial risk assignment (using diagnoses reported by the family) and final risk assignment (using confirmed diagnoses) was no greater than 72.3 % in 1,363 breast cancer families; a similar effect was seen in 764 colorectal cancer families (77.3 %). Clinically important risk reassignment occurred at the three key stages in the risk assessment pathway. Overall, genetic risk was reassigned in almost 30 % of colorectal families and 20 % of breast cancer families, resulting in a change in screening recommendation and/or referral for tertiary genetic assessment. Careful, detailed family history assessment, with confirmation of reported diagnoses where it may affect risk assignment, is an important process for the point of view of patient management and resource allocation.


Family history Triage Risk assessment Service development 



The authors wish to acknowledge Macmillan Cancer Support for their financial and educational input during the pilot phase of this service development; and the clinical and administrative support provided by Angela Russell, Jackie Patton and Kay Hutchinson.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Northern Genetics Service, Teesside Genetics UnitJames Cook University HospitalMiddlesbroughUK
  2. 2.Macmillan Cancer Family History ServiceJames Cook University HospitalMiddlesbroughUK

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