Family history of cancer can be an evolving story

By Shari Roan, Los Angeles Times / For the Booster Shots blog

1:12 PM PDT, July 12, 2011

Family history is an incredibly helpful tool for doctors trying to determine a patient's risk of cancer. But one family history intake will not suffice. Rather, family history needs to updated every five or 10 years, according to the authors of a new study.

Researchers at UC Irvine looked at thousands of adults with a personal or family history of cancer and found that many changes in one's family history of breast, colorectal and prostate cancer occur between age 30 and 50. Based on their findings, the authors suggest that a patient's family history (of first- or second-degree relatives) of cancer be updated occasionally.

Family history is often used to determine how often a person should be screened for various types of cancers, the authors note. People with an increased risk due to family history may need to undergo more screening or start screening at a younger age.

"Family health history data are more likely to be collected at the initial clinic visit and are not adequately updated during follow-up visits," the authors wrote. "If a patient's family history is not updated during early and middle adulthood, the opportunity may be missed to intervene with earlier or more intensive screening that maximizes the likelihood of detecting cancer at an early, treatable stage."

The frequency of cancer screening tests has become a topic of debate in recent years as medical experts try to balance the benefits of screening against the potential risks and costs and move to personalize screening recommendations. With the increasing use of electronic health records, it may become easier to efficiently update family history records, said the author of an editorial accompanying the study. But how much family history matters when personalizing cancer screening recommendations is not clear.

"[M]uch needed evidence about the population health benefits of early and intensified cancer screening according to familial risk has yet to be developed," wrote Dr. Louise S. Acheson of Case Western Reserve University School of Medicine.

The study is published in the Journal of the American Medical Assn.