Ozanne Elissa M, O'Connell Adrienne, Bouzan Colleen, Bosinoff Phil, Rourke Taryn, Dowd Dana, Drohan Brian, Millham Fred, Griffin Pat, Halpern Elkan F, Semine Alan, Hughes Kevin S
Institute for Health Policy Studies, Department of Surgery, University of California, San Francisco, CA, USA.
J Genet Couns. 2012 Aug;21(4):547-56. doi: 10.1007/s10897-011-9470-x. Epub 2012 Jan 12.
Family history of cancer is critical for identifying and managing patients at risk for cancer. However, the quality of family history data is dependent on the accuracy of patient self reporting. Therefore, the validity of family history reporting is crucial to the quality of clinical care. A retrospective review of family history data collected at a community hospital between 2005 and 2009 was performed in 43,257 women presenting for screening mammography. Reported numbers of breast, colon, prostate, lung, and ovarian cancer were compared in maternal relatives vs. paternal relatives and in first vs. second degree relatives. Significant reporting differences were found between maternal and paternal family history of cancer, in addition to degree of relative. The number of paternal family histories of cancer was significantly lower than that of maternal family histories of cancer. Similarly, the percentage of grandparents' family histories of cancer was significantly lower than the percentage of parents' family histories of cancer. This trend was found in all cancers except prostate cancer. Self-reported family history in the community setting is often influenced by both bloodline of the cancer history and the degree of relative affected. This is evident by the underreporting of paternal family histories of cancer, and also, though to a lesser extent, by degree. These discrepancies in reporting family history of cancer imply we need to take more care in collecting accurate family histories and also in the clinical management of individuals in relation to hereditary risk.
癌症家族史对于识别和管理癌症高危患者至关重要。然而，家族史数据的质量取决于患者自我报告的准确性。因此，家族史报告的有效性对临床护理质量至关重要。对一家社区医院在2005年至2009年期间收集的43257名接受乳腺钼靶筛查的女性的家族史数据进行了回顾性分析。比较了母系亲属与父系亲属以及一级亲属与二级亲属中报告的乳腺癌、结肠癌、前列腺癌、肺癌和卵巢癌的病例数。除了亲属程度外，还发现母系和父系癌症家族史之间存在显著的报告差异。父系癌症家族史的数量显著低于母系癌症家族史。同样，祖父母癌症家族史的比例显著低于父母癌症家族史的比例。除前列腺癌外，在所有癌症中均发现了这种趋势。社区环境中自我报告的家族史往往受到癌症家族史的血统和受影响亲属程度的影响。父系癌症家族史报告不足以及亲属程度报告不足（尽管程度较轻）都证明了这一点。癌症家族史报告中的这些差异意味着我们在收集准确的家族史以及对个体进行与遗传风险相关的临床管理时需要更加谨慎。
