Impact of increased understanding of personal and family health history on patients.

256 Background: The InheRET personal and family health history survey was administered to 384 patients at three Michigan Medicine Clinics (2 primary care (11% of patients) and one breast and ovarian cancer risk clinic (89% of patients)) between October 1, 2018 and May 31, 2019. Since family history alone misses ~30% of those with deleterious germline mutations, this study follows these patients to determine what, if any, impact completion of the histories had on patients’ lifestyle choices, cancer prevention screenings, and risk-reducing therapies adopted based on perceived risk status: Meeting or not meeting NCCN Guidelines for referral to genetics for further evaluation. Methods: One year after patients completed their health histories, a follow-up survey was emailed to patients inquiring into actions taken following completion of the InheRET health history form. Anonymous responses were automatically collected into a Google Datasheet and analyzed. Results: As of June 16, 2020, 61 patients had returned their surveys; 37 (60.7%) reported being referred to a genetics specialist, of whom 92% kept their counseling appointments and 100% of these were recommended to be tested. At the time of survey completion, 29 patients had been tested and 32 patients had not been tested. We analyzed the actions taken between these two groups and discovered that 75% of patients who did not meet NCCN Guidelines and were not recommended for counseling and testing (population risk patients) still made lifestyle changes to improve their health and engaged in at least one cancer screening activity in the past year to reduce their cancer risk. The only preventive medical treatments received by this group were Tamoxifen (12.9%) and Hormone Replacement Therapy (3.2%). Among patients meeting NCCN Guidelines and tested (4 positive, 17 negative, 8 inconclusive/VUS/unknown results), 58.6% made positive lifestyle choices, 86.5% engaged in one or more cancer screening activities, and 34.5% sought additional medical interventions such as chemoprevention, hormone replacement and/or prophylactic surgery. Conclusions: By learning more about their personal and family health histories, patients who did not meet referral guidelines and were not referred for counseling and testing were proactive in taking actions to improve their overall health and reduce their cancer risk. This demonstrates the importance of knowing and understanding one’s family health history, even for those not meeting NCCN referral guidelines.