Familial Cancer

, Volume 7, Issue 3, pp 229–232 | Cite as

Family history of cancer in Brazil: is it being used?

  • Danilo V. Viana
  • Juvenal R. N. Góes
  • Cláudio S. R. Coy
  • Maria de Lourdes Setsuko Ayrizono
  • Carmen S. P. Lima
  • Iscia Lopes-Cendes


In developing countries, low budgets make the issue of integrating genetics into clinical practice a challenge, a situation in which the use of family history (FH) becomes important for patient care, as it is a low cost strategy and a risk assessment tool. The purpose of this study was to review medical records of patients with colorectal cancer (CRC) seen in a public University Hospital and evaluate how often FH of cancer is registered. Initially we searched a database for patients who were seen in our hospital between 2002 and 2004 with the diagnosis of CRC. We found 415 patients, 104 of whom were excluded. A total of 311 charts were reviewed and classified into 3 groups. Group A: no FH documented; group B: FH was documented, but FH of cancer was not collected; and group C: FH of cancer was documented. We also investigated what type of information was recorded, in order to verify if important elements were assessed. Ninety-eight charts (31.5%) were classified in group A, 20 (6.5%) in group B, and 193 (62%) in group C. In addition, we observed that important information regarding affected relatives was not collected in most of the charts. In conclusion, we found that although FH of cancer was recorded in 62% of charts of patients with CRC, information that could be relevant for risk assessment and management of at-risk families was missing. Our findings expose an important problem in health education that could reflect negatively in the quality of medical assistance to individuals at risk for familial cancer.


Cancer Colorectal cancer Family history Genetics Hereditary cancer syndromes Heredity Medical history taking Pedigree Prevention Risk assessment 



Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (a Brazilian public research funding agency)


Colorectal cancer


Familial adenomatous polyposis


Family history


Hereditary nonpolyposis colorectal cancer


Sistema Único de Saúde (Brazilian Public Health System)



We are grateful to Dr. Mark Greene from the National Cancer Institute/NIH for his thoughtful ideas. Financial support was provided for Danilo Viana by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a Brazilian federal agency for research funding. The authors declare no conflicting interests.


  1. 1.
    Teixeira HV, Teixeira MG (2003) Financiamento da Saude pública no Brasil: a expriência do SIOPS (Public health financing in Brazil: the Siops experience). Ciência e Saúde Coletiva 8(2):379–391Google Scholar
  2. 2.
    Scheuner MT, Wang SJ, Raffel LJ, Larabell SK, Rotter JI (1997) Family history: a comprehensive genetic risk assessment method for the chronic conditions of adulthood. Am J Med Genet 71(3):315–324PubMedCrossRefGoogle Scholar
  3. 3.
    Yoon PW, Scheuner MT, Khoury MJ (2003) Research priorities for evaluating family history in the prevention of common chronic diseases. Am J Prev Med 24(2):128–135PubMedCrossRefGoogle Scholar
  4. 4.
    Ramsey SD, Burke W, Pinsky L, Clarke L, Newcomb P, Khoury MJ (2005) Family history assessment to detect increased risk for colorectal cancer: conceptual considerations and a preliminary economic analysis. Cancer Epidemiol Biomarkers Prev 14(11):2494–2500PubMedCrossRefGoogle Scholar
  5. 5.
    Guttmacher AE, Collins FS, Carmona RH (2004) The family history–more important than ever. N Engl J Med 351(22):2333–2336PubMedCrossRefGoogle Scholar
  6. 6.
    Rich EC, Burke W, Heaton CJ, Haga S, Pinsky L, Short MP et al (2004) Reconsidering the family history in primary care. J Gen Intern Med 19(3):273–280PubMedCrossRefGoogle Scholar
  7. 7.
    Khoury MJ, Little J, Burke K (2004) Human genome epidemiology. New York: Oxford University PressGoogle Scholar
  8. 8.
    Love RR, Evans AM, Josten DM (1985) The accuracy of patient reports of a family history of cancer. J Chronic Dis 38(4):289–293PubMedCrossRefGoogle Scholar
  9. 9.
    Sweet KM, Bradley TL, Westman JA (2002) Identification and referral of families at high risk for cancer susceptibility. J Clin Oncol 20(2):528–537PubMedCrossRefGoogle Scholar
  10. 10.
    Severin M (1999) Genetic susceptibility for specific cancers: medical liability of the clinician. Cancer 86:2564–2569PubMedCrossRefGoogle Scholar
  11. 11.
    Lynch HT (2002) Cancer family history and genetic testing: are malpractice adjudications waiting to happen? Am J Gastroenterol 97(3):51CrossRefGoogle Scholar
  12. 12.
    Lynch HT, Follett KL, Lynch PM, Albano WA, Mailliard JL, Pierson RL (1979) Family history in an oncology clinic: implications for cancer genetics. JAMA 242(12):1268–1272PubMedCrossRefGoogle Scholar
  13. 13.
    Church J, McGannon E (2000) Family history of colorectal cancer: how often and how accurately is it recorded? Dis Colon Rectum 43(11):1540–1544PubMedCrossRefGoogle Scholar
  14. 14.
    Murff HJ, Byrne D, Syngal S (2004) Cancer risk assessment: quality and impact of the family history interview. Am J Prev Med 27(3):239–245PubMedGoogle Scholar
  15. 15.
    Fuchs CS, Giovannucci EL, Colditz GA, Hunter DJ, Speizer FE, Willett WC (1994) A prospective study of family history and the risk of colorectal cancer. N Engl J Med 331(25):1669–1674PubMedCrossRefGoogle Scholar
  16. 16.
    Lynch HT, Lynch PM, Albana WA (1979) Hereditary cancer: ascertainment and management. CA Cancer J Clin 29:216–232PubMedCrossRefGoogle Scholar
  17. 17.
    St. John DJB, McDermott FT, Hopper LJ, Debney EA, Johnson WR, Hughes ESR (1993) Cancer risk in relatives of patients with common colorectal cancer. Ann Intern Med 118:785–790PubMedGoogle Scholar
  18. 18.
    Manne S, Markowitz A, Winawer S, Guillem J, Meropol NJ, Haller D et al (2003) Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: a test of a mediational model. Prev Med 36:71–84PubMedCrossRefGoogle Scholar
  19. 19.
    Lynch HT, Boland CR, Rodriguez-Bigas MA, Amos C, Lynch JF, Lynch PM (2007) Who should be sent for genetic testing in hereditary colorectal cancer syndromes? J Clin Oncol 25(23):3534–3542PubMedCrossRefGoogle Scholar
  20. 20.
    Umar A, Risinger JI, Hawk ET, Barrett JC (2004) Testing guidelines for hereditary non-polyposis colorectal cancer. Nat Rev Cancer 4(2):153–158PubMedGoogle Scholar
  21. 21.
    Boardman LA (2002) Heritable colorectal cancer syndromes: recognition and preventive management. Gastroenterol Clin N Am 31:1107–1131CrossRefGoogle Scholar
  22. 22.
    Vasen HFA, Möslein G, Alonso A, Bernstein I, Bertario L, Blanco I et al (2007) Guidelines for the clinical management of Lynch syndrome (hereditary non-polyposis cancer). J Med Genet 44:353–362PubMedCrossRefGoogle Scholar
  23. 23.
    van Dijk DA, Oostindiër MJ, Kloosterman-Boele WM, Krijnen P, Vasen HFA (2007) Family history is neglected in the work-up of patients with colorectal cancer: a quality assessment using cancer registry data. Fam Cancer 6:131–134PubMedCrossRefGoogle Scholar
  24. 24.
    Umar A, Boland CR, Terdiman JP, Syngal S, de la Chapelle A, Rüschoff J et al (2004) Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 96(4):261–268PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Danilo V. Viana
    • 1
  • Juvenal R. N. Góes
    • 2
  • Cláudio S. R. Coy
    • 2
  • Maria de Lourdes Setsuko Ayrizono
    • 2
  • Carmen S. P. Lima
    • 3
  • Iscia Lopes-Cendes
    • 1
  1. 1.Department of Medical Genetics, Faculty of Medical SciencesFCM-UNICAMPCampinasBrazil
  2. 2.Department of Surgery, Faculty of Medical SciencesFCM-UNICAMPCampinasBrazil
  3. 3.Department of Clinical Medicine, Faculty of Medical SciencesFCM-UNICAMPCampinasBrazil

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