Family Cancer Histories Are Not Highly Accurate

Sensitivity and positive predictive value of reports on four major cancers is low to moderate

WEDNESDAY, May 18 (HealthDay News) -- General population reports on family history for major adult cancers are not very accurate, according to a study published online May 11 in the Journal of the National Cancer Institute.

Phuong L. Mai, M.D., from the National Institutes of Health in Bethesda, Md., and colleagues analyzed the accuracy of reported family cancer history for 1,019 participants in the 2001 Connecticut Family Health Survey. Family history was reported for breast, colorectal, prostate, and lung cancers in 2,605 out of 20,578 first- (FDR) and second-degree relatives (SDR) and was confirmed using state cancer registries, Medicare databases, National Death Index, death certificates, and health care facility records. Positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity after stratification by sex, age, education, and degree of relatedness were used to estimate report accuracy.

The investigators found that sensitivity and PPV were low to moderate for each cancer type: 60.2 and 40 percent, respectively, for lung cancer; 27.3 and 53.5 percent for colorectal cancer; 61.1 and 61.3 percent for breast cancer; and 32 and 53.4 percent for prostate cancer reports. The NPV and specificity for all four cancer types was more than 95 percent. Significantly higher sensitivity was seen for prostate cancer and significantly higher PPVs were seen for lung, colorectal, and breast cancer, for FDR compared to SDR.

"Family cancer history collected in the primary care setting might be useful as an initial screening tool and, if positive, confirmation of the reported cancers is needed for the purpose of making cancer screening recommendations or referral to a specialty clinic," the authors write.

The study was partially funded by Westat Inc.

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