Cancer Risk Assessment: Examining the Family Physician’s Role

Background: Cancer risk assessment begins in the primary care clinician’s office. Essential components of that process include: 1) documentation of personal and family cancer information; 2) identification of families at increased risk for cancer; 3) modification of cancer screening recommendations according to degree of risk; 4) referral of high-risk individuals to cancer genetics clinics. The purpose of this study was to examine these 4 components of primary care cancer risk assessment using data abstracted from patient records at an academic family medicine center. Methods: Ambulatory records of 734 patients were reviewed in their entirety for information rele-vant to cancer risk assessment. Detail of cancer information was categorized as comprehensive, ade-quate, or inadequate. Patient records were categorized as suggestive of average, moderate, or high ge-netic risk for cancer. For patients with a family history of colorectal cancer, modification of colon cancer screening to reflect degree of cancer risk was assessed. Finally, the frequency of cancer genetic referral in high-risk individuals was noted. Results: The presence or absence of a family history of cancer was documented in 97.8 % of records. There was insufficient information to adequately assess risk in 69.5 % of charts. Detail of family cancer documentation was associated with personal history of cancer (P .001), patient age (P .001), an