Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA; Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA.
Prev Med. 2013 Nov;57(5):679-84. doi: 10.1016/j.ypmed.2013.08.031. Epub 2013 Sep 9.
Previous research on ascertainment of cancer family history and cancer screening has been conducted in urban settings.
To examine whether documented family history of breast or colorectal cancer is associated with breast or colorectal cancer screening.
Medical record reviews were conducted on 3433 patients aged 55 and older from four primary care practices in two rural Oregon communities. Data collected included patient demographic and risk information, including any documentation of family history of breast or colorectal cancer, and receipt of screening for these cancers.
A positive breast cancer family history was associated with an increased likelihood of being up-to-date for mammography screening (OR 2.09, 95% CI 1.45-3.00 relative to a recorded negative history). A positive family history for colorectal cancer was associated with an increased likelihood of being up-to-date with colorectal cancer screening according to U.S. Preventive Services Task Force low risk guidelines for males (OR 2.89, 95% CI 1.15-7.29) and females (OR 2.47, 95% CI 1.32-4.64) relative to a recorded negative family history. The absence of any recorded family cancer history was associated with a decreased likelihood of being up-to-date for mammography screening (OR 0.70, 95% CI 0.56-0.88 relative to recorded negative history) or for colorectal cancer screening (OR 0.75, 95% CI 0.60-0.96 in females, OR 0.68, 95% CI 0.53-0.88 in males relative to recorded negative history).
Further research is needed to determine if establishing routines to document family history of cancer would improve appropriate use of cancer screening.
先前有关癌症家族史和癌症筛查的确定的研究是在城市环境中进行的。
研究是否有乳腺癌或结直肠癌的家族病史与乳腺癌或结直肠癌的筛查有关。
对来自俄勒冈州两个农村社区的四个初级保健诊所的 3433 名 55 岁及以上的患者进行病历回顾。收集的数据包括患者的人口统计学和风险信息，包括任何有关乳腺癌或结直肠癌家族史的记录，以及对这些癌症的筛查情况。
乳腺癌家族史阳性与接受乳房 X 线照片筛查的可能性增加相关（与记录为阴性的家族史相比，比值比为 2.09，95%置信区间为 1.45-3.00）。结直肠癌家族史阳性与符合美国预防服务工作组针对男性（比值比为 2.89，95%置信区间为 1.15-7.29）和女性（比值比为 2.47，95%置信区间为 1.32-4.64）低风险指南的结直肠癌筛查可能性增加相关，与记录为阴性的家族史相比。没有记录任何家族癌症史与接受乳房 X 线照片筛查（与记录为阴性的家族史相比，比值比为 0.70，95%置信区间为 0.56-0.88）或结直肠癌筛查（女性为 0.75，95%置信区间为 0.60-0.96，男性为 0.68，95%置信区间为 0.53-0.88）的可能性降低相关，与记录为阴性的家族史相比。
需要进一步研究以确定是否建立记录癌症家族史的常规程序是否会改善癌症筛查的合理应用。
