Abstract
PURPOSE: Although important for the diagnosis of familial clustering of colorectal cancer and hereditary nonpolyposis colorectal cancer, the accuracy of familial cancer history assessment in the office setting has been questioned. Furthermore, there are few publications describing the optimal method for accurately capturing a family cancer history. The purpose of this study was to determine how well family cancer history is assessed in patients with early age-of-onset colorectal cancer at initial surgical consultation compared with a telephone interview and mailed questionnaire. METHODS: Medical records of patients 40 years old or younger at the time of colorectal cancer surgery were reviewed for documentation of family cancer history at initial surgical consultation. In addition, family cancer history was solicited from surviving patients or their next of kin by telephone and a mailed questionnaire. The kappa coefficient was used to measure degree of correlation between family cancer history obtained at initial surgical consultation and subsequent telephone interview and questionnaire. RESULTS: One hundred twenty-five patients were available for analysis. Family cancer history was documented on the initial surgical consultation report in 78 percent of cases. Although 31.2 percent were identified as having no family cancer history at initial surgical consultation, this proportion decreased to 13.5 percent after telephone interviews and questionnaires. Family history assessment at initial surgical consultation also failed to identify 7 of 11 individuals meeting Amsterdam criteria for hereditary nonpolyposis colorectal cancer and 10 of 16 individuals meeting modified clinical criteria for hereditary nonpolyposis colorectal cancer. CONCLUSIONS: Although family cancer history was commonly obtained during the initial surgical consultation of patients with colorectal cancer, there was a tendency to underestimate the extent of familial cancer. A telephone interview and questionnaire conducted at a later date may reveal a more comprehensive family cancer history. This is an important observation, because individuals identified as high-risk for hereditary nonpolyposis colorectal cancer or familial clustering of colorectal cancer require special consideration with respect to screening, surveillance, and surgical management.
Similar content being viewed by others
References
Lovett E. Family studies in cancer of the colon and rectum. Br J Surg 1976;63:13–8.
Bonelli L, Martines H, Conio M,et al. Family history of colorectal cancer as a risk factor for benign and malignant tumours of the large bowel. A case-control study. Int J Cancer 1988;41:513–7.
Guillem JG, Neugut AI, Forde KA,et al. Colonic neoplasms in asymptomatic first-degree relatives of colon cancer patients. Am J Gastroenterol 1988;83:271–3.
St. John DJ, McDermott FT, Hopper JL,et al. Cancer risk in relatives of patients with common colorectal cancer. Ann Intern Med 1993;118:785–90.
Fuchs CS, Giovannucci EL, Colditz GA,et al. A prospective study of family history and the risk of colorectal cancer. N Engl J Med 1994;331:1669–74.
Burt RW, DiSario JA, Cannon-Albright L. Genetics of colon cancer: impact of inheritance on colon cancer risk. Ann Rev Med 1995;46:371–9.
Slattery ML, Kerber RA. Family history of cancer and colon cancer risk: the Utah Population Database. J Natl Cancer Inst 1994;86:1618–26.
Napier JA, Metzner H, Johnson BC. Limitations of morbidity and mortality data obtained from family histories—a report from the Tecumseh community health study. Am J Public Health 1972;62:30–5.
Love RR, Evans AM, Josten DM. The accuracy of patient reports of a family history of cancer. J Chronic Dis 1985;38:289–93.
Theis B, Boyd N, Lockwood G, Tritchler D. Accuracy of family cancer history in breast cancer patients. Eur J Cancer Prev 1994;3:321–7.
Aitken J, Bain C, Ward M,et al. How accurate is self-reported family history of colorectal cancer? Am J Epidemiol 1995;141:863–71.
Kerber RA, Slattery ML. comparison of self-reported and database-linked family history of cancer data in a case-control study. Am J Epidemiol 1997;146:244–8.
Glanz K, Grove J, Le Marchand L, Gotay C. Underreporting of family history of colon cancer: correlates and implications. Cancer Epidemiol Biomarkers Prev 1999;8:635–9.
Guillem JG, Puig-La Calle J Jr, Cellini C,et al. Varying features of early age-of-onset “sporadic” and hereditary nonpolyposis colorectal cancer patients. Dis Colon Rectum 1999;42:36–42.
Vasen HF, Mecklin JP, Khan PM, Lynch HT. The International Collaborative Group on Hereditary NonPolyposis Colorectal Cancer (ICG-HNPCC). Dis Colon Rectum 1991;34:424–5.
Hall NR, Finan PJ, Ward B,et al. Genetic susceptibility to colorectal cancer in patients under 45 years of age. Br J Surg 1994;81:1485–9.
Byers T, Levin B, Rothenberger D,et al. American Cancer Society guidelines for screening and surveillance for early detection of colorectal polyps and cancer: update 1997. American Cancer Society Detection and Treatment Advisory Group on Colorectal Cancer. CA Cancer J Clin 1997;47:154–60.
Statement of the American Society of Clinical Oncology. Genetic testing for cancer susceptibility. Adopted on February 20, 1996. J Clin Oncol 1996;14:1730–40.
Lynch HT, Smyrk T, Lynch J. An update of HNPCC (Lynch syndrome). Cancer Genet Cytogenet 1997;93:84–99.
Fitzgibbons RJ Jr, Lynch HT, Stanislav GV,et al. Recognition and treatment of patients with hereditary nonpolyposis colon cancer (Lynch syndromes I and II). Ann Surg 1987;206:289–95.
Lynch HT, Smyrk TC, Watson P,et al. Genetics, natural history, tumor spectrum, and pathology of hereditary nonpolyposis colorectal cancer: an updated review. Gastroenterology 1993;104:1535–49.
DeCosse JJ. Surgical prophylaxis of familial colon cancer: prevention of death from familial colorectal cancer. J Natl Cancer Inst Monogr 1995;17:31–2.
Burke W, Petersen G, Lynch P,et al. Recommendations for follow-up care of individuals with an inherited predisposition to cancer. I. Hereditary nonpolyposis colon cancer. Cancer Genetics Studies Consortium. JAMA 1997;277:915–9.
Menko FH, Wijnen JT, Khan PM,et al. Genetic counseling in hereditary nonpolyposis colorectal cancer. Oncology (Huntingt) 1996;10:71–6.
Lynch HT. Is there a role for prophylactic subtotal colectomy among hereditary nonpolyposis colorectal cancer germline mutation carriers? Dis Colon Rectum 1996;39:109–10.
Rodriguez-Bigas MA, Boland CR, Hamilton SR,et al. A National Cancer Institute Workshop on Hereditary Nonpolyposis Colorectal Cancer Syndrome: meeting highlights and Bethesda guidelines. J Natl Cancer Inst 1997;89:1758–62.
Lynch HT, Lemon SJ, Karr B,et al. Etiology, natural history, management and molecular genetics of hereditary nonpolyposis colorectal cancer (Lynch syndromes): genetic counseling implications. Cancer Epidemiol Biomarkers Prev 1997;6:987–91.
Author information
Authors and Affiliations
Additional information
Supported in part by the Grace J. Fippinger Foundation and by the William Bianco Trust.
About this article
Cite this article
Ruo, L., Cellini, C., La-Calle, J.P. et al. Limitations of family cancer history assessment at initial surgical consultation. Dis Colon Rectum 44, 98–103 (2001). https://doi.org/10.1007/BF02234829
Issue Date:
DOI: https://doi.org/10.1007/BF02234829