Table 1.
Current state of cancer family history collection in clinical practice
| Statistically significant differences between clinical practice groupsa | ||||
|---|---|---|---|---|
| Survey item | Participant responses, N (%) |
Ob/Gyn vs. Gen Med and NPs |
Gen Med vs. Ob/Gyn and NPs |
NPs vs. Ob/Gyn and Gen Med |
| Do you regularly complete family histories/pedigrees on cancer risk for your patients? | ||||
| Yes | 110 (77.5) | 6.3 (2.2–18.2); P = 0.0006 | NS | 0.1 (0.04–0.3); P < 0.0001 |
| No | 32 (22.5) | |||
| If “yes,” how often do you update these family histories/pedigrees on cancer risk? | ||||
| Never | 24 (22.2) | NS | NS | NS |
| Once a year | 62 (57.4) | |||
| Several times a year | 12 (11.1) | |||
| At every visit, regardless of purpose of visit | 10 (9.3) | |||
| If “yes,” which of the following kinds of information do these family histories/pedigrees routinely include (all that apply)? | ||||
| First-degree relatives | 99 (69.2) | 3.9 (1.7–9.2); P = 0.002 | NS | 0.2 (0.1–0.5); P = 0.002 |
| Second-degree relatives | 58 (40.6) | 3.1 (1.5–6.7); P = 0.004 | NS | 0.3 (0.1–0.9); P = 0.02 |
| Type of cancer | 88 (62.4) | 3.9 (1.7–8.6); P = 0.0009 | NS | 0.2 (0.01–0.4); P < 0.0001 |
| Age at time of diagnosis | 62 (43.4) | NS | NS | 0.2 (0.1–0.6); P = 0.003 |
| Family history maternal | 69 (48.3) | NS | NS | 0.40 (0.2–0.9); P = 0.04 |
| Family history paternal | 62 (43.4) | NS | NS | 0.40 (0.2–0.9); P = 0.03 |
| All above information | 37 (25.9) | 3.3 (1.4–7.8); P = 0.007 | NS | 0.3 (0.1–0.9); P = 0.05 |
| If “yes,” how would you rate your level of skill related to interpreting cancer risk (low, moderate, high) based on family history/pedigree information you collect and subsequent prevention, screening, and treatment recommendations (1 = novice, 5 = expert) | ||||
| 1 = novice | 13 (11.3) | 0.4 (SE = 0.2); P = 0.03 | NS | −0.7 (SE = 0.3); P = 0.01 |
| 2 | 38 (33.0) | |||
| 3 | 43 (37.4) | |||
| 4 | 19 (16.5) | |||
| 5 = expert | 2 (1.7) | |||
| Which of the following barriers to collecting cancer family history and risk information do you currently face in your practice (all that apply)? | ||||
| Ability to identify low, moderate high risk cases and provide appropriate risk management | 42 (29.4) | NS | NS | NS |
| Language and cultural barriers with patients | 36 (25.2) | NS | NS | NS |
| Lack of patient knowledge about cancer family history | 64 (44.8) | NS | 2.9 (1.2–6.8); P = 0.02 | 0.09 (0.03–0.3); P = 0.0002 |
| Lack of time for practitioner to collect cancer family history information | 64 (44.8) | 3.8 (1.8–8.2); P = 0.0006 | NS | 0.1 (0.04–0.4); P = 0.0002 |
| Lack of time for practitioner to interpret information, provide appropriate risk management and counseling | 39 (27.3) | 2.7 (1.2–6.3); P = 0.02 | NS | 0.06 (0.008–0.5); P = 0.0007 |
a
Reporting odds ratios (95% confidence intervals) and P values for dichotomous variables. Reporting beta coefficient (standard error) and P values for continuous variables.
NS, not significant; Gen Med, general medicine; NP, nurse practitioner.