University of Vermont

College of Medicine

Vermont Cancer Center

Wood ASCO Presentation Focuses on Importance of Cancer Family History

Professor of Medicine Marie Wood, M.D.
Professor of Medicine Marie Wood, M.D. (Photo by Raj Chawla, UVM Medical Photography)

Clinical trial findings presented at the American Society for Clinical Oncology (ASCO) annual meeting – attended by roughly 30,000 cancer specialists from around the world – often impacts the current standards of care for cancer patients. On June 4, 2012, research presented by Marie Wood, M.D., University of Vermont professor of medicine and director of the Familial Cancer Program at the Vermont Cancer Center, was highlighted at the meeting.

Wood is lead author of a study, sponsored in part by ASCO, titled “Quality of Cancer Family History and Referral for Genetic Counseling and Testing among Oncology Practices.” More than 200 doctors’ offices and treatment centers associated with ASCO’s Quality Oncology Practice Initiative (QOPI) participated in the study. QOPI is a national program designed to measure the care provided to patients so each doctor’s office or treatment center that participates in the program can use that information to improve the cancer care they provide.

“An accurate family history and appropriate referral to genetic testing are important for a patient’s treatment and follow-up care, as well as for their family members,” said Wood in an article in the June 4, 2011 Cancer Advances: News for Patients from the 2012 ASCO Annual Meeting.

The process of cancer family history-taking, however, has some holes. According to Wood and her colleagues, earlier studies show a link between a low rate of family history documentation and low referral rates for genetic counseling and genetic testing.

ASCO set out to evaluate the practice of patient family history-taking and related referrals for genetic testing through a QOPI pilot test, run in fall 2011. Specifically, the group zeroed in on the practice in patients with either a history of breast cancer or colorectal cancer, assessing the presence or absence of cancer family history in first/second degree relatives, age at cancer diagnosis, referral for genetic counseling/testing, and outcomes of referral. First degree relatives include a parent, sibling or child, and second-degree relatives include a grandparent, grandchild, aunt or uncle.

The research team examined more than 10,000 medical records. While the group found that 77 percent of the patients’ medical records included first-degree cancer family history information, and 61 percent included second-degree family history information, less than a third of those records included the age at which the family members were diagnosed with cancer. In addition, a total of 22 percent of patients were referred for genetic counseling/testing. Of those, 54 percent were referred for breast cancer genetic counseling/testing and 26 percent were referred for colorectal cancer counseling/testing. Wood says that the history-taking was more accurate in the breast cancer history group than that colorectal cancer history group, and there were higher referral rates among breast cancer patients.

“In this pilot testing of QOPI measures, we identified a higher quality of CFH information than expected though with room for improvement,” say the study’s authors.

Based on their findings, the group recommends provider education to help make significant, needed improvements in the practice of cancer family history-taking and appropriate referral.