Dr. Wood on Family Histories and Genetic Counseling

Marie Wood, MD, professor of medicine, director of the Familial Cancer Program and deputy director of hematology/oncology at University of Vermont, discusses a large 213-practice, 10,466-patient study that assessed the quality of familial cancer history documentation and referrals to genetic counseling for patients with breast and colorectal cancers.

The trial used the new Quality Oncology Practice Initiative (QOPI) test, developed by ASCO in 2011, to evaluate the familial history of cancer in first- or second-degree relatives of those diagnosed with breast or colorectal cancers. Additionally, the test examined the age at cancer diagnosis, whether there was a referral to receive genetic counseling or testing, and the outcomes of the referrals.

Wood notes that 77% of first-degree relatives were documented for those with breast and colorectal cancers; however, the amount of individuals with a documented second-degree family history was only 61% for both groups. Establishing a second-degree link is important for determining whether a syndrome is hereditary, Wood explained. Additionally, when considering age, less than one third of patients documented the age that cancer was diagnosed for their relatives. The age is vital, because, in general, if cancer develops at a younger age it is more likely to be related to a hereditary cause.

In the trial, the examination of genetic counseling and testing practices found that 22% of patients received referrals. Of those with a hereditary risk, 52% patients with breast cancer received counseling or testing compared to only 26% with colorectal cancer, representing a dramatic difference between the two groups. Overall, the trial found that patients with breast cancer had a more thorough documentation of their family history than those with colorectal cancer.

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