Family history in colonoscopy patients: feasibility and performance of electronic and paper-based surveys for colorectal cancer risk assessment in the outpatient setting
Tannaz GuivatchianErika KoeppeJason BakerCristina MoisaMatthew DemerathCaitlin Foor-PessinWilliam D. CheyShanti EswaranJoseph C. KolarsStacy B. MeneesMichael W. RajalaMichael RiceRafat RizkJoel H. RubensteinPratima SharmaAndrea TodiscoElena M. Stoffel
12
Citation
19
Reference
10
Related Paper
Citation Trend
Keywords:
Lynch Syndrome
Outpatient clinic
Medical History
Aim: To determine the prevalence of diabetes and to explore various modifiable and nonmodifiable factors associated with diabetes in Ahmednagar city. Method: The data was then collected using convenient sampling method. The subjects were selected from VPMH hospital, various camps and door to door survey. The subjects were assessed based on the assessment form including Demographic data, Socio-economic data, Family history, Medical history, Surgical history, Personal history, B.M.I., Waist Hip ratio, Diabetes history, Drug history and human activity profile questionnaire. Result: 38.6% of adult diagnosed with diabetes in Ahmednagar city population the prevalence came out to be 46.6% among males and 30.5% in females. The mean age for male and female are 57.3 years and 57.2 years respectively. About 47.8% diabetic samples belongs to upper middle class and 4.3% belongs to lower class. 58.6% have a positive family history and 41.3% have a negative family history. 50% have no medical history and 30.4% have positive history of HTN and 3.5% have positive history of CVD and HTN & CVD. Conclusion: The mean age for diabetes in male is 57.3% and for female is 57.2%. The mean duration of diabetes in males is 13.1 year in males and 9.8 year in females. This is mostly the first study to include use of sugar in beverage by diabetic population i.e. 56.5% out total diabetic population
Cite
Citations (0)
Abstract Purpose To estimate the cost-effectiveness of genetic testing for Lynch syndrome among newly diagnosed patients with colorectal cancer and targeted testing for their relatives in Switzerland. Methods We integrated decision tree and Markov model to calculate incremental costs per quality adjusted life-year saved for universal genetic testing for Lynch syndrome relative to using preliminary tumor tests (immunohistochemistry or microsatellite instability) followed by DNA sequencing test for patients with colorectal cancer. Results The incremental cost-effectiveness ratio (ICER) of the proposed strategy using universal genetic testing for Lynch syndrome with systematic CASCADE testing of their relatives is CHF 65,058 per QALY saved, which is cost-effective in Swiss settings where cost-effectiveness threshold is CHF 100,000 per QALY saved. The gained utility is 361,358 QALYs saved. Sensitivity analysis demonstrated cost-effectiveness of the proposed strategies in most of the scenarios. Conclusions The overall effectiveness of the universal genetic testing is greatly dependent on willingness of patients and relatives to be tested and compliance with the increased surveillance. Therefore, close cooperation across different stakeholders such as family doctors, oncologists, genetic clinicians, and laboratories is crucial to encourage and educate patients about the importance of the LS screening. Key messages Universal genetic testing for Lynch syndrome for all patients with colorectal caner is cost-effective in Swiss settings. Close cooperation across all stakeholders such as family doctors, oncologists, genetic clinicians, and laboratories is crucial to encourage and educate patients about the importance of the LS testing.
Lynch Syndrome
Microsatellite Instability
Hereditary Cancer
Cite
Citations (0)
Lynch Syndrome
Prophylactic Surgery
Cite
Citations (1)
Family health history can be a valuable indicator of risk to develop certain cancers. Unfortunately, patient self-reported family history often contains inaccuracies, which might change recommendations for cancer screening. We endeavored to understand the difference between a patient's self-reported family history and their electronic medical record (EMR) family history. One aim of this study was to determine if family history information contained in the EMR differs from patient-reported family history collected using a focused questionnaire.We created the Hereditary Cancer Questionnaire (HCQ) based on current guidelines and distributed to 314 patients in the Department of Family Medicine waiting room June 20 to August 1, 2018. The survey queried patients about specific cancers within their biological family to assess their risk of an inherited cancer syndrome. We used the questionnaire responses as a baseline when comparing family histories in the medical record.Agreement between the EMR and the questionnaire data decreased as the patients' risk for familial cancer increased. Meaning that the more significant a patient's family cancer history, the less likely it was to be recorded accurately and consistently in the EMR. Patients with low-risk levels, or fewer instances of cancer in the family, had more consistencies between the EMR and the questionnaire.Given that physicians often make recommendations on incomplete information that is in the EMR, patients might not receive individualized preventive care based on a more complete family cancer history. This is especially true for individuals with more complicated and significant family history of cancer. An improved method of collecting family history, including increasing patient engagement, may help to decrease this disparity.
Medical History
Medical record
Electronic medical record
Past medical history
Cite
Citations (3)
Lynch Syndrome
Cite
Citations (8)
Medical History
Medical record
Past medical history
Cite
Citations (46)
Aim To determine whether the family history predicts the development of allergic diseases in infants at 18 months or 6 months.Methods 304 infants were followed up by telephone or were asked to come to clinic four times. All data were analyzed statistically to use SPSS11.0 for Windows.Results 77 infants had family history of the allergic disease, rated 57.1%.The corresponding figures of the infants with no family history were 38.3%. There was significant difference between two groups in the development of the allergic diseases (P=0.004). Statistical analysis showed there was significant correlation between father's allergic history and the urticaria of the infants. The mother's allergic history was related to dermatitis of the infants.The parental history was related to recurrent wheezing of the infants.The PPV of the family history was 55.8%,the specificity 80.5%,the sensitivity 33.1%.Conclusion The positive family history was dangerous to the allergic disease of the infants.
Medical History
Clinical history
Cite
Citations (0)
Of the estimated 150,000 colorectal cancer (CRC) cases diagnosed annually, approximately 30% have a familial basis and 3% to 5% are from high-penetrance inherited cancer syndromes. Lynch syndrome, or hereditary nonpolyposis colorectal cancer, caused by inherited germline mutations in mismatch repair (MMR) genes, is the most commonly inherited CRC syndrome. It is characterized by young-onset CRC and an increased risk for extracolonic tumors, including gynecologic, urinary tract, and other gastrointestinal cancers. Commercial testing is available for mutations in the MMR genes, but testing all patients with CRC would be economically prohibitive. Therefore, a comprehensive evaluation of a multigenerational family cancer history is essential for the identification of at-risk individuals. The presence of tumors diagnosed at a young age, multiple first- and second-degree relatives with cancer, or 2 or more primary cancers may be indicative of an inherited cancer syndrome and these individuals should undergo genetic evaluation. Genetic test results, when conclusive, can guide management for patients and their families. However, indeterminate test results may provide false reassurance to patients who should be managed as being at higher-than-average risk. Online risk assessment tools and commercial genetic testing offer the potential to identify a greater number of at-risk individuals at an earlier age. However, for these measures to improve outcomes, patients must receive screening recommendations and counseling appropriate for their cancer risk.
Lynch Syndrome
Penetrance
Predictive testing
Cancer screening
Cite
Citations (25)
Abstract Lynch syndrome is the most common inherited cancer syndrome that increases the risk of developing colorectal and endometrial cancer. Universal screening guidelines were first recommended by the Centers for Disease Control and Prevention (CDC) in 2009 and are updated annually by multiple societies. Therefore, one would expect genetic testing rates to increase over time. But testing remains underutilized among those with colorectal or endometrial cancer, even though early detection can improve prognosis and survival rates. In this study, we aimed to understand differences in genetic testing uptake among those with colorectal cancer or endometrial cancer from 2005, 2010, 2015, using data from the National Health Interview Survey (NHIS). We examined genetic testing uptake across cancer-type, age (≤50 or ≥51), sex, race, insurance, and education using a χ2 statistical analysis. Despite an upward genetic testing trend in 2010, we found no significant differences in genetic testing uptake over time. In 2010, non-White individuals experienced the highest increase from 2005 in comparison with White individuals. However, genetic testing rates declined for both groups by 2015. Our findings show that genetic testing for colorectal cancer and endometrial cancer did not increase over a 10-year period in spite of guidelines that recommend testing. Prevention Relevance: Genetic testing uptake for colorectal cancer and endometrial cancer has not increased over a 10-year period in spite of universal screening guidelines. More genetic testing education is needed at the provider and patient level to improve screening strategies for cancer patients who are most at risk for Lynch syndrome.
Lynch Syndrome
Cancer Prevention
Cancer screening
Cite
Citations (10)