Accuracy of family history of cancer

Evidence Summaries

Level of Evidence = B
Self-reported family histories of site-specific cancer appear accurate for breast and colon cancer in first-degree relatives. Reports for other cancers and second-degree relatives are more variable in accuracy.

A systematic review 1 including 14 cohort studies was abstracted in DARE. To be eligible for inclusion, the studies had to check the disease status or cause of death for family members identified as having cancer (positive family history) and also check the disease status or cause of death of all relatives reported as not having cancer (negative family history). For people with a personal history of cancer, the LR of a positive self-reported family history of cancer among a first-degree relative was 23.0 for colon cancer, 41.0 for breast cancer, 20.0 for endometrial cancer, 44.0 for ovarian cancer, and 24.0 for prostate cancer. For people with a personal history of cancer, the LR of a negative self-reported family history of cancer among a first-degree relative was 0.29 for colon cancer, 0.07 for breast cancer, 0.55 for endometrial cancer, 0.21 for ovarian cancer, and 0.25 for prostate cancer. For people without a personal history of cancer, the LR of a positive self-reported family history of cancer among a first-degree relative was 23.0 for colon cancer, 8.9 for breast cancer, 14.0 for endometrial cancer, 34.0 for ovarian cancer, and 12.3 for prostate cancer. For people without a personal history of cancer, the LR of a negative self-reported family history of cancer among a first-degree relative was 0.25 for colon cancer, 0.20 for breast cancer, 0.68 for endometrial cancer, 0.51 for ovarian cancer, and 0.32 prostate cancer.

Comment: The quality of evidence is upgraded by strong association.

References

1. Murff HJ, Spigel DR, Syngal S. Does this patient have a family history of cancer? An evidence-based analysis of the accuracy of family cancer history. JAMA 2004 Sep 22;292(12):1480-9.  [PMID:15383520]

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