224999 Implementing a family history screening tool to identify individuals with cancer susceptibility in a primary care setting: The Colorado Generations service project

Wednesday, November 10, 2010 : 9:00 AM - 9:15 AM

Jan Lowery, PhD, MPH , Epidemiology, University of Colorado School of Public Health, Aurora, CO
Lisa Ku, MSGC , Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO
Lisen Axell, MSGC , Cancer Prevention and Control, University of Colorado Cancer Center, Aurora, CO
Thomas Gottlieb, MD , Denver Oncology Consortium, Golden, CO
Introduction: Cancer remains a significant public health burden. Individuals with genetic susceptibility have significant lifetime cancer risk but if identified, can be given recommendations for medical management to decrease their risk. Lacking are systematic methods for collecting adequate family histories to identify high-risk individuals. This project sought to increase awareness about hereditary cancer and to facilitate identification of at-risk individuals through a family history screening tool. Methods: A family history screening tool was implemented within primary care and oncology clinics in the Denver area to identify patients at-risk for hereditary cancer. Educational sessions for providers were conducted in tandem. Patients identified as high-risk were navigated to receive follow-up, genetic counseling and testing as appropriate. Results: Educational sessions were conducted at 18 clinics for 115 providers. Over 10,000 individuals were screened; 1,600 (16%) were identified as high risk and mailed education about hereditary cancer along with a family history questionnaire for further evaluation. Of those subsequently referred (150), 81 received counseling and 48 had genetic testing. Individuals counseled were provided screening recommendations and strategies for risk reduction. Services for uninsured patients were covered by the project. Conclusions: This project demonstrated that a screening tool can effectively identify patients at-risk for hereditary cancer in a primary care setting. The major challenge was getting patients to follow-through on referral for counseling. Future efforts to increase awareness and utilization of genetic services may focus on educating providers and addressing barriers for seeking services for at-risk patients.

Learning Areas:
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education

Learning Objectives:
1. Describe 3 barriers for patients making referral appointments for genetic counseling. 2. List 2 ways to integrate a chronic disease referral system into primary care practices. 3. Explain 2 ways that a similar project can be expanded.

Keywords: Cancer Prevention, Genetics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principal Investigator for this project
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.