Cancer screening can be improved with updated family histories

By Deborah Kotz, Globe Staff

The next time you head to your doctor’s office for a check-up, make sure to reveal whether any close family members developed cancer since your last visit. You might need to get certain screening tests earlier than the recommended time -- and your doctor might not know to make a referral unless you update your family history.

A study involving 27,000 patients published in the Journal of the American Medical Association yesterday found a significant percentage of those ages 30 to 50 had changes in their family medical histories that would qualify them to, say, have a colonoscopy before the typical recommended age of 50 or to have breast MRI screening -- more sensitive to picking up tumors -- instead of mammograms.

The researchers from the Massachusetts General Hospital and other institutions found that at age 30, some two percent of participants met the criteria for early colonoscopy based on their family history of colon cancer which rose to seven percent by age 50. For breast cancer, about seven percent of the women qualified for MRI at age 30 based on family history and other factors; by age 50, more than 11 percent qualified.

“Family histories change significantly between the ages of 30 and 50 years,” wrote the researchers. “We therefore recommend that family history should be updated at least every 5 to 10 years to appropriately inform recommendations for cancer screening.”

In an editorial accompanying the study Dr. Louise Acheson, a family physician and oncologist at Case Western Reserve University School of Medicine, wondered whether updated family histories might led to delayed cancer screenings for those without a particular cancer in their family. “It is possible that, if family history of cancer and breast cancer risk status were reliably updated during the decade from ages 40 to 50 years, many lower-risk women in that age group, as in England, might forgo mammography screening.”