title: Family and personal history in colorectal cancer patients: what are we missing?
abstract: OBJECTIVE
  Family and personal history of colorectal cancer and associated tumours are crucial in identifying families with hereditary nonpolyposis colorectal cancer (HNPCC). The aim of this study was to determine the adequacy of these aspects of history-taking in the management of colorectal cancer patients.
  
  
  METHODS
  Colorectal cancer patients attending outpatient follow-up were interviewed to obtain a detailed family and personal history of cancers. The medical notes were then reviewed to identify whether these had been documented previously.
  
  
  RESULTS
  One hundred and one patients took part. In seven, no family history had been recorded; none of these actually had a significant pedigree. In 88, the family history was not significant, a finding correctly documented in the records. Three had a high-risk family history and another three had a personal history of other possible HNPCC-related cancers. In each of these patients, the relevant findings had been documented, but no further action had been taken.
  
  
  CONCLUSIONS
  Family history was taken in the majority of patients, but in the only three with a pedigree indicative of HNPCC, its significance was not appreciated. The potential relevance of multiple HNPCC-related cancers in the same individual was also overlooked. Improved education and referral pathways are needed to ensure that families with HNPCC have access to appropriate surveillance and genetic testing.
authors.affiliation: Centre for Academic Surgery, Barts and the London, Queen Mary's School of Medicine and Dentistry, London University, London, UK.
authors.forename: V O
authors.initials: VO
authors.lastname: Alberto
authors.forename: C J
authors.initials: CJ
authors.lastname: Harocopos
authors.forename: A A
authors.initials: AA
authors.lastname: Patel
authors.forename: S K
authors.initials: SK
authors.lastname: Clark
mesh_terms: D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy*; D005260:Female; D020022:Genetic Predisposition to Disease; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D010375:Pedigree; D010818:Practice Patterns, Physicians'; D012307:Risk Factors