Joseph Cioffi, MD, Danielle Kirelik, BS, Lauren Pascual, MPH, BS, Marie Borum, MD, EdD, MPH
George Washington University, Washington, DC
Approximately 5-10% of cancers are attributable to hereditary cancer syndromes. It is recommended that a preliminary risk assessment for colon cancer include a family history in first and second degree relatives, genetic testing when appropriate and tumor analysis when possible. GI providers can optimize clinical decisions regarding colon cancer screening by obtaining multi-generational family history. However it is uncertain if providers consistently document family history for possible referral for genetic testing. This study evaluated rates of multi-generational family history documentation by GI providers in patients referred for colon cancer screening at a university medical center.
Methods: A retrospective chart review of all patients referred for colon cancer screening to the gastroenterology clinic during a 3 month period was performed. Patient gender, age, race, indication for CRC screening, documentation of a family history (3+ generations) was obtained. A confidential database was generated using Microsoft Excel. Statistical analysis using Fisher’s Exact Test was performed with significance set at p< 0.05. The study was approved by the institutional IRB.
872 medical records (500 females, 372 males) with a mean age of 59.2 (range 29-89) were reviewed. Self-reported race / ethnicity included 452 Black / African-American, 363 White, 54 Hispanic, 42 Asian, 36 other and 34 undocumented. 144 (16.51%) had a multi-generational family history. Detailed family history was obtained significantly more often in females (102; 20.4%) compared to males (41; 11.02%) (p=0.0023) and in whites (58; 22.05%) compared to non-whites (77; 13.39%) (p=0.0023). Female providers were significantly more likely to obtained a detailed family history compared to male providers (26.9% vs 9.81%) (p=0.0001).
Discussion: This study revealed that there was inconsistent documentation of multi-generational family history by GI providers in patients referred for colon cancer screening. Females and whites were more likely to have family risk assessment. Female providers more frequently obtained detailed family histories. While this study is limited due to duration and single institution design, it provides important information for subsequent studies and educational intervention. It is important that there is optimal assessment of colon cancer risk in effort to improve early detection and outcomes.
Citation: Joseph Cioffi, MD, Danielle Kirelik, BS, Lauren Pascual, MPH, BS, Marie Borum, MD, EdD, MPH. P0239 - FAMILY COMES FIRST: GI PROVIDERS MAY INCONSISTENTLY PERFORM MULTI-GENERATIONAL FAMILY HISTORY WHEN ASSESSING COLON CANCER RISK. Program No. P0239. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.