Tuesday, January 10, 2012

Cancer Screening Improved Through Detailed Family Histories

Dianne Finkelstein

Dianne Finkelstein, PhD, of the Massachusetts General Hospital Biostatics Center
Read more at massgeneralmag.org

A recent study concluded that family history can significantly affect the course of action for cancer screenings such as mammograms and colonoscopies. “We wanted to find out whether changes in a person’s family history of cancer, over time, would affect the screening schedule and tests recommended by standard guidelines,” says Dianne Finkelstein, PhD, of the Massachusetts General Hospital Biostatistics Center. “The results of our study could guide how often healthcare providers should update their patients’ family histories.” For example, a 42-year-old woman with no family history of colorectal cancer should have a first colonoscopy at age 50 and a repeat exam every 10 years. However, if the patient learned that her 46-year-old brother had been diagnosed with colon cancer, the guidelines would call for an immediate colonoscopy and screening every five years.

The study focused specifically on colorectal, breast and prostate cancer. It analyzed detailed family history participants reported upon enrollment — reflecting their cancer risk up until that time — as well as updated information provided annually over an average of eight years.

Results revealed that with the new information, the percentage of participants aged 30 to 50 whose risk of colorectal cancer increased enough to affect screening recommendations more than tripled. The percentage of women aged 30 to 50 with a change in breast cancer risk signaling a need for a breast MRI increased nearly 60 percent. Men aged 30 to 50 demonstrated a smaller but still significant increase in prostate cancer risk and screening need.

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