Table 1.

Algorithms for assessing disease risk based solely on FH

DISEASE	LEVEL OF FH RISK: SELF-REPORT	FH RISK ASSESSMENT ALGORITHM: SELF-REPORT	LEVEL OF FH RISK: EMR	FH RISK ASSESSMENT ALGORITHM: EMR	RECOMMENDED SCREENING
Diabetes21	Average	Does not fit into elevated category	Average	Does not fit into elevated category	FPG level measured every 3 y starting at age 40 y
	Elevated	First-degree relative with diabetes	Elevated	First-degree relative with diabetes	FPG level measured every y
CAD22	Average	Does not fit into elevated category	Average	Does not fit into elevated category	NA
	Elevated	First-degree relative diagnosed with CAD* at age < 60 y	Elevated	First-degree relative diagnosed with CAD* at age < 60 y	NA
BC23	Average	Does not fit into elevated category (either moderate- or high-risk category)	Average	No FH of BC or ovarian cancer	Mammogram every 2 y for women aged 50–69 y
	Elevated: moderate risk	1 first- or second-degree relative with BC at age 35–49 y OR 2 first- or second-degree relatives on the same side of the family with BC at age < 70 y	Elevated	Any relative with BC or ovarian cancer	Mammogram every y for women aged 40–69 y
	Elevated: high risk	3 relatives on same side of the family with BC OR 2 first- or second-degree relatives on same side of the family with BC at age < 50 y OR 1 first- or second-degree relative with any of BC at age < 35 y or ovarian cancer at any age OR 1 male relative with BC OR first- or second-degree Ashkenazi Jewish relative with BC at age < 50 y
CRC24,25	Average	No FH of CRC	Average	No FH of CRC	FOBT every 2 y or sigmoidoscopy every 5 y or colonoscopy every 10 y starting at age 50 y
	Low: slightly increased risk	Might have 1 second- or third-degree relative with CRC
	Elevated: mildly increased risk	1 first-degree relative with CRC at age > 60 y OR ≥ 2 second-degree relatives from same side of the family with CRC	Elevated	Any relative with CRC	FOBT every 2 y or colonoscopy every 10 y starting at age 40 y
	Elevated: moderate to high risk	1 first-degree relative with CRC at age ≤ 60 y OR ≥2 first-degree relatives with CRC at any age			Colonoscopy every 5 y starting at age 40 y or 10 y earlier than age of youngest family member at time of diagnosis, which ever comes first

BC—breast cancer, CAD—coronary artery disease, CRC—colorectal cancer, EMR—electronic medical record, FH—family history, FOBT—fecal occult blood testing, FPG—fasting plasma glucose, NA—not applicable.

^*CAD included angina, myocardial infarction, congestive heart failure, and CAD.