This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (62)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Men's Health  • Prostate Disease  • Oncology  • Breast Cancer  • Colon Cancer  • The Rational Clinical Examination  • Gastroenterology  • Gastrointestinal Diseases  • Genetics  • Genetic Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

An Evidence-Based Analysis of the Accuracy of Family Cancer History

Harvey J. Murff, MD, MPH; David R. Spigel, MD; Sapna Syngal, MD, MPH

JAMA. 2004;292:1480-1489.

Context  A family history of certain cancers is associated with an increased risk of developing cancer. Both cancer screening and genetic services referral decisions are often based on self-reported pedigree information.

Objective  To determine the accuracy of self-reported family cancer history information.

Data Sources  English-language articles were retrieved by searching MEDLINE (1966-June 2004) using Medical Subject Headings family, genetic predisposition to disease, medical history taking, neoplasm, and reproducibility of results. Additional articles were identified through bibliography searches.

Study Selection  Original studies in which investigators validated self-reported family history by reviewing the identified relatives' medical records, death certificate, or cancer registry information were included, as well as studies that evaluated breast, colon, ovarian, endometrial, and prostate cancers.

Data Extraction  Two of the 3 investigators independently reviewed and abstracted data for estimating the likelihood ratios (LRs) of self-reported family cancer history information. Only data from studies that evaluated both positive and negative family cancer histories were included within the analyses. A total of 14 studies met the search criteria and were included in the review.

Data Synthesis  For patients without a personal history of cancer, the positive and negative LRs of a family history of the following cancers in a first-degree relative were 23.0 (95% confidence interval [CI], 6.4-81.0) and 0.25 (95% CI, 0.10-0.63) for colon cancer; 8.9 (95% CI, 5.4-15.0) and 0.20 (95% CI, 0.08-0.49) for breast cancer; 14.0 (95% CI, 2.2-83.4) and 0.68 (95% CI, 0.31-1.52) for endometrial cancer; 34.0 (95% CI, 5.7-202.0) and 0.51 (95% CI, 0.13-2.10) for ovarian cancer; and 12.3 (95% CI, 6.5-24.0) and 0.32 (95% CI, 0.18-0.55) for prostate cancer, respectively. Positive predictive values tended to be better in articles concerning first-degree relatives compared with second-degree relatives.

Conclusions  Patient-reported family cancer histories for first-degree relatives are accurate and valuable for breast and colon cancer risk assessments. Negative family history reports for ovarian and endometrial cancers are less useful, although the prevalence of these malignancies within families is low.

Author Affiliations: Division of General Internal Medicine, Vanderbilt University Medical Center, and Department of Veterans Affairs, Tennessee Valley Healthcare System (Dr Murff), and the Sarah Cannon Cancer Center (Dr Spigel), Nashville, Tenn; Division of Gastroenterology, Brigham and Women's Hospital and Population Sciences Division, Dana-Farber Cancer Institute, Boston, Mass (Dr Syngal).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Population-based, Case-Control-Family Design to Investigate Genetic and Environmental Influences on Melanoma Risk: Australian Melanoma Family Study
Cust et al.
Am J Epidemiol 2009;0:kwp307v1-kwp307.
ABSTRACT | FULL TEXT  

Risk of Pancreatic Cancer in Families With Lynch Syndrome
Kastrinos et al.
JAMA 2009;302:1790-1795.
ABSTRACT | FULL TEXT  

Family history of melanoma and Parkinson disease risk
Gao et al.
Neurology 2009;73:1286-1291.
ABSTRACT | FULL TEXT  

Diagnosis and management of hereditary colorectal cancer syndromes: Lynch syndrome as a model
Lynch et al.
CMAJ 2009;181:273-280.
FULL TEXT  

Will the History and Physical Examination Help Establish That Irritable Bowel Syndrome Is Causing This Patient's Lower Gastrointestinal Tract Symptoms?
Ford et al.
JAMA 2008;300:1793-1805.
ABSTRACT | FULL TEXT  

Interviews with primary care physicians regarding taking and interpreting the cancer family history
Wood et al.
Fam Pract 2008;25:334-340.
ABSTRACT | FULL TEXT  

Familial risks for chronic obstructive pulmonary disease among siblings based on hospitalisations in Sweden
Hemminki et al.
J. Epidemiol. Community Health 2008;62:398-401.
ABSTRACT | FULL TEXT  

Colonoscopy Screening in African Americans and Whites With Affected First-Degree Relatives
Murff et al.
Arch Intern Med 2008;168:625-631.
ABSTRACT | FULL TEXT  

Multiple Diagnostic X-rays for Spine Deformities and Risk of Breast Cancer
Ronckers et al.
Cancer Epidemiol. Biomarkers Prev. 2008;17:605-613.
ABSTRACT | FULL TEXT  

Familial Risks for Cancer as the Basis for Evidence-Based Clinical Referral and Counseling
Hemminki et al.
The Oncologist 2008;13:239-247.
ABSTRACT | FULL TEXT  

Estimating risks of common complex diseases: familial and population risks
Hemminki et al.
J. Med. Genet. 2008;45:126-127.
FULL TEXT  

How common is familial cancer?
Hemminki et al.
Ann Oncol 2008;19:163-167.
ABSTRACT | FULL TEXT  

Family History in Pediatric Primary Care
Trotter and Martin
Pediatrics 2007;120:S60-S65.
ABSTRACT | FULL TEXT  

Risk of Bladder Cancer Associated with Family History of Cancer: Do Low-Penetrance Polymorphisms Account for the Increase in Risk?
Murta-Nascimento et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:1595-1600.
ABSTRACT | FULL TEXT  

Breast Cancer in First-degree Relatives and Risk of Lung Cancer: Assessment of the Existence of Gene-Sex Interactions
Tsuchiya et al.
Jpn J Clin Oncol 2007;0:hym048v1-5.
ABSTRACT | FULL TEXT  

Racial Differences in Cancer Risk Among Relatives of Patients With Early Onset Lung Cancer
Naff et al.
Chest 2007;131:1289-1294.
ABSTRACT | FULL TEXT  

Non-Hodgkin's Lymphoma and Family History of Hematologic Malignancy
Mensah et al.
Am J Epidemiol 2007;165:126-133.
ABSTRACT | FULL TEXT  

Familial risks for nerve, nerve root and plexus disorders in siblings based on hospitalisations in Sweden
Hemminki et al.
J. Epidemiol. Community Health 2007;61:80-84.
ABSTRACT | FULL TEXT  

Family History of Cancer and the Risk of Renal Cell Cancer
Negri et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:2441-2444.
ABSTRACT | FULL TEXT  

Prediction of MLH1 and MSH2 mutations in Lynch syndrome.
Balmana et al.
JAMA 2006;296:1469-1478.
ABSTRACT | FULL TEXT  

Family History of Hemolymphopoietic and Other Cancers and Risk of Non-Hodgkin's Lymphoma.
Negri et al.
Cancer Epidemiol. Biomarkers Prev. 2006;15:245-250.
ABSTRACT | FULL TEXT  

Genetic Risk Assessment and BRCA Mutation Testing for Breast and Ovarian Cancer Susceptibility: Systematic Evidence Review for the U.S. Preventive Services Task Force
Nelson et al.
ANN INTERN MED 2005;143:362-379.
ABSTRACT | FULL TEXT  

Spectral Markers in Preneoplastic Intestinal Mucosa: An Accurate Predictor of Tumor Risk in the MIN Mouse
Roy et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:1639-1645.
ABSTRACT | FULL TEXT  

Risk of Lung Cancer Among White and Black Relatives of Individuals With Early-Onset Lung Cancer
Cote et al.
JAMA 2005;293:3036-3042.
ABSTRACT | FULL TEXT  

Alteration of Gene Expression in Macroscopically Normal Colonic Mucosa from Individuals with a Family History of Sporadic Colon Cancer
Hao et al.
Clin. Cancer Res. 2005;11:1400-1407.
ABSTRACT | FULL TEXT