Family history in an oncology clinic. Implications for cancer genetics
H. T. Lynch, K. L. Follett, P. M. Lynch, W. A. Albano, J. L. Mailliard and R. L. Pierson
Detailed family histories of cancer were solicited from 200 consecutively
ascertained cancer patients undergoing treatment in an oncology clinic.
Approximately 18% had two or more first-degree relatives with cancer of any
anatomic site. In several cases, striking familial aggregations of cancer
fulfilled more rigorous criteria for hereditary cancer syndromes, including
early age at onset of generally late-occurring tumors, characteristic tumor
patterns, vertical transmission, and collateral family lines similarly
afflicted. Review of preexisting clinic charts demonstrated that, in most
cases, the family history of cancer had been either omitted altogether,
reported as negative despite substantial evidence to the contrary, or, if
noted as positive, not pursued or acted on. Family history can be more
successfully utilized in recognition of suggestive familial cancer
aggregations, ultimate identification of hereditary cancer syndromes, and
control of cancer in clinical practice.
