Cancer Family History Guide

A Tool for Providers

The Cancer Family History Guide was created by the Michigan Department of Community Health with the Centers for Disease Control and Prevention Office of Public Health Genomics.

Cancer Family History Guide chart

What Genetic Conditions Does it Look For?

  • Hereditary Breast and Ovarian Cancer syndrome (HBOC)
  • Lynch syndrome (or HNPCC)

Which patients do I use it for?

  • Those with a family history of breast, ovarian, colorectal, or endometrial (uterine) cancer
  • Include 1st and 2nd degree relatives only in the risk assessment (i.e. mother, father, sister, brother, children, aunts, uncles, grandparents, or grandchildren)
  • **Note: If a patient has a personal history of breast, ovarian, endometrial (uterine), colorectal, fallopian tube or primary peritoneal cancer, this guide is not appropriate.

What is the purpose of this clinical tool?

If a significant family history is reported, the tool indicates that:

  • a patient referral for genetic counseling and further evaluation is appropriate; and
  • increased screening and consideration of management options are indicated

How long does this risk assessment take?

The guide can be used quickly during clinic time and takes approximately 2 minutes or less to address a family history of breast, ovarian, colorectal, or endometrial cancers **Note: If a patient has a personal history of any of the following, genetic counseling should be considered:

  • Breast cancer under age 50 or ovarian cancer at any age
  • Ovarian cancer and a close relative with breast or ovarian cancer
  • Bilateral cancer or multiple cancer diagnoses (i.e. both breast and ovarian cancer)
  • Breast or ovarian cancer and Ashkenazi Jewish descent
  • Breast cancer in a male patient (at any age)
  • Colon cancer or uterine cancer under age 50
  • 10 or more gastrointestinal polyps

Special Considerations:

When assessing family history, it is important to consider factors that may artificially make a family's risk seem lower than it is. These include: a disproportionate number of males to females; adoption; or multiple women with a hysterectomy/oophorectomy at a young age (reason unspecified).

View the Instruction Card (PDF)

Download the Provider Order Form (PDF) (this guide is currently available free of charge to any Michigan healthcare provider)

MDCH Poster Presentation

"Creating a Clinical Risk Assessment Tool to Promote Cancer Genomics Best Practices in the State of Michigan" (PDF poster)

Creating a Clinical Risk Assessment Tool to Promote Cancer Genomics (PDF presentation)

References

US Preventive Services Task Force (USPSTF) Recommendation Statement on BRCA1/2 Counseling and Testing (PDF)

National Comprehensive Cancer Network guidelines regarding Lynch Syndrome (PDF)