Abusamaan Mohammed S, Quillin John Martin, Owodunni Oluwafemi, Emidio Oluwabunmi, Kang In Guk, Yu Brandon, Ma Brittany, Bailey Lauryn, Razzak Rab, Smith Thomas J, Bodurtha Joann N
1 Johns Hopkins University School of Medicine, Baltimore MD, USA.
2 Virginia Commonwealth University, Richmond, VA, USA.
Am J Hosp Palliat Care. 2018 Dec;35(12):1490-1497. doi: 10.1177/1049909118778865. Epub 2018 May 29.
: Hereditary cancer assessment and communication about family history risks can be critical for surviving relatives. Palliative care (PC) is often the last set of providers before death.
: We replicated a prior study of the prevalence of hereditary cancer risk among patients with cancer receiving PC consultations, assessed the history in the electronic medical record (EMR), and explored patients' attitudes toward discussions about family history. This study was conducted at an academic urban hospital between June 2016 and March 2017.
: The average age of the 75 adult patients with cancer was 60 years, 49 (55%) male and 49 (65%) white. A total of 19 (25%) patients had no clear documentation of family history in the EMR, sometimes because no family history was included in the admission template or an automatically imported template lacked content. In all, 24 (32%) patients had high-risk pedigrees that merited referral to genetic services. And, 48 (64%) patients thought that PC was an appropriate venue to discuss the implications of family history. The mean comfort level in addressing these questions was high.
: At an academic center, 25% of patients had no family history documented in the EMR. And, 32% of pedigrees warranted referral to genetic services, which was rarely documented. There is substantial room for quality improvement for oncologists and PC specialists-often the last set of providers-to address family cancer risk before death and to increase use and ease of documenting family history in the EMR. Addressing cancer family history could enhance prevention, especially among high-risk families.
遗传性癌症评估以及关于家族病史风险的沟通对于幸存的亲属可能至关重要。姑息治疗（PC）通常是患者临终前的最后一批医疗服务提供者。
我们重复了一项先前的研究，该研究针对接受PC咨询的癌症患者中遗传性癌症风险的患病率进行了评估，在电子病历（EMR）中查看了病史，并探讨了患者对家族病史讨论的态度。本研究于2016年6月至2017年3月在一家城市学术医院进行。
75名成年癌症患者的平均年龄为60岁，其中49名（55%）为男性，49名（65%）为白人。共有19名（25%）患者的电子病历中没有明确的家族病史记录，有时是因为入院模板中未包含家族病史，或者自动导入的模板缺乏相关内容。总体而言，24名（32%）患者具有高风险的家系，值得转介至基因服务机构。此外，48名（64%）患者认为PC是讨论家族病史影响的合适场所。处理这些问题时的平均舒适度较高。
在一个学术中心，25%的患者电子病历中没有家族病史记录。并且，32%的家系值得转介至基因服务机构，但这很少被记录。肿瘤学家和PC专科医生（通常是最后一批医疗服务提供者）在患者临终前处理家族癌症风险以及增加在电子病历中记录家族病史的使用率和便捷性方面，仍有很大的质量改进空间。处理癌症家族病史可以加强预防，尤其是在高风险家庭中。
