Experience and Perceptions of a Family Health History Risk Assessment Tool among Multi-Ethnic Asian Breast Cancer Patients

A family health history-based risk assessment is particularly valuable for guiding cancer screening and treatment strategies, yet an optimal implementation depends upon end-users’ values and needs. This is not only true prior to disease development, but also for those already affected. The aim of this study is to explore perceptions of the value of knowing one’s family health history (FHH)-based risk, experience using a patient-facing FHH tool and the potential of the tool for wider implementation. Twenty multi-ethnic Asian patients undergoing breast cancer treatment in Singapore completed an FHH-based risk assessment. Semi-structured one-on-one interviews were conducted and data were thematically analyzed. All participants were female and slightly more than half were Chinese. The acceptance and usage of an FHH risk assessment tool for cancers and its broader implementation was affected by a perceived importance of personal control over early detection, patient concerns of anxiety for themselves and their families due to risk results, concerns for genetic discrimination, adequacy of follow-up care plans and Asian cultural beliefs toward disease and dying. This study uniquely sheds light on the factors affecting Asian breast cancer patients’ perceptions about undergoing an FHH-based risk assessment, which should inform steps for a broader implementation in Asian healthcare systems.

Download Full-text

Clinical implementation of an oncology‐specific family health history risk assessment tool

Hereditary Cancer in Clinical Practice ◽

10.1186/s13053-021-00177-y ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Si Ming Fung ◽

R. Ryanne Wu ◽

Rachel A. Myers ◽

Jasper Goh ◽

Geoffrey S. Ginsburg ◽

...

Keyword(s):

Breast Cancer ◽

Risk Assessment ◽

Genetic Counseling ◽

Genetic Testing ◽

Cancer Patients ◽

Family Health ◽

Family Health History ◽

Hereditary Cancer Syndromes ◽

Health History ◽

Cancer Syndromes

Abstract Background The presence of hereditary cancer syndromes in cancer patients can have an impact on current clinical care and post-treatment prevention and surveillance measures. Several barriers inhibit identification of hereditary cancer syndromes in routine practice. This paper describes the impact of using a patient-facing family health history risk assessment platform on the identification and referral of breast cancer patients to genetic counselling services. Methods This was a hybrid implementation-effectiveness study completed in breast cancer clinics. English-literate patients not previously referred for genetic counselling and/or gone through genetic testing were offered enrollment. Consented participants were provided educational materials on family health history collection, entered their family health history into the platform and completed a satisfaction survey. Upon completion, participants and their clinicians were given personalized risk reports. Chart abstraction was done to identify actions taken by patients, providers and genetic counsellors. Results Of 195 patients approached, 102 consented and completed the study (mean age 55.7, 100 % women). Sixty-six (65 %) met guideline criteria for genetic counseling of which 24 (36 %) were referred for genetic counseling. Of those referred, 13 (54 %) participants attended and eight (33 %) completed genetic testing. On multivariate logistic regression, referral was not associated with age, cancer stage, or race but was associated with clinical provider (p = 0.041). Most providers (71 %) had higher referral rates during the study compared to prior. The majority of participants found the experience useful (84 %), were more aware of their health risks (83 %), and were likely to recommend using a patient-facing platform to others (69 %). Conclusions 65 % of patients attending breast cancer clinics in this study are at-risk for hereditary conditions based on current guidelines. Using a patient-facing risk assessment platform enhances the ability to identify these patients systematically and with widespread acceptability and recognized value by patients. As only a third of at-risk participants received referrals for genetic counseling, further understanding barriers to referral is needed to optimize hereditary risk assessment in oncology practices. Trial Registration NIH Clinical Trials registry, NCT04639934. Registered Nov 23, 2020 -- Retrospectively registered.

Download Full-text

Abstract P3-08-10: Highly accurate hereditary risk assessment tool for low-income breast cancer patients

10.1158/1538-7445.sabcs16-p3-08-10 ◽

2017 ◽

Author(s):

GL Wiesner ◽

SK Rao ◽

DR Ashworth ◽

KA Thomas ◽

PE Lammers

Keyword(s):

Breast Cancer ◽

Risk Assessment ◽

Cancer Patients ◽

Low Income ◽

Assessment Tool ◽

Risk Assessment Tool ◽

Breast Cancer Patients ◽

Hereditary Risk

Download Full-text

The enduring importance of family health history in the era of genomic medicine and risk assessment

Personalized Medicine ◽

10.2217/pme-2019-0091 ◽

2020 ◽

Vol 17 (3) ◽

pp. 229-239 ◽

Cited By ~ 1

Author(s):

Susanne B Haga ◽

Lori A Orlando

Keyword(s):

Risk Assessment ◽

Assessment Tool ◽

Disease Risk ◽

Traditional Approach ◽

Genomic Medicine ◽

Family Health ◽

Family Health History ◽

Environmental Data ◽

Implementation Challenges ◽

Health History

Improving disease risk prediction and tailoring preventive interventions to patient risk factors is one of the primary goals of precision medicine. Family health history is the traditional approach to quickly gather genetic and environmental data relevant to the patient. While the utility of family health history is well-documented, its utilization is variable, in part due to lack of patient and provider knowledge and incomplete or inaccurate data. With the advances and reduced costs of sequencing technologies, comprehensive sequencing tests can be performed as a risk assessment tool. We provide an overview of each of these risk assessment approaches, the benefits and limitations and implementation challenges.

Download Full-text