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Obtain family history two generations up and two generations down
from patient
- If a relative has cancer, extend history "back" as far
as possible
- For each relative record: age or year of birth, age of death, year
and cause of death
- Ask about any cancer diagnosis in relatives, and include:
age of diagnosis, primary site(s) of cancer, cancer status (and ages)
of children of the relative(s) with cancer
- Identify predisposing environmental factors including: high fat
or red meat diet, pelvic radiation, smoking, obesity, alcohol abuse
- Ask about treatment for cancer
- Confirm diagnosis with pathology reports
- Does anyone have:
- GI tract
cancers (colon, stomach, small bowel, pancreas, liver and bile-duct)?
- Non-GI cancers,
specifically brain, endometrial, bladder, ovarian, breast, and
testicular cancers?
- Unusual freckles
on the face, hands, feet or genital area?
- Unusual lumps
on the skin (e.g., epidermoid cysts, fibromatosis, desmoid tumors)?
- Bony lesions
(e.g., exostoses, osteomas)?
- A history
of fibrocystic breasts, ovarian cysts, or thyroid disease/cancer?
- Numerous
colonic polyps?
- Inflammatory
bowel disease?
- Ask about genetic
disease in general including birth defects, miscarriages, and mental
retardation
- Record ethnicity of all four grandparents, and record consanguinity
(i.e., parents related as first cousins)
- Note the historian (the person who gave the family history)
- Document the date the pedigree was obtained, and by whom
- Put an arrow to the individual(s) seen at the appointment
- Include a key/legend interpreting pedigree symbols (e.g. shading) |
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