The Role of Palliative Medicine in Assessing Hereditary Cancer Risk

Mohammed S. Abusamaan, John Martin Quillin, Oluwafemi Owodunni, Oluwabunmi Emidio, In Guk Kang, Brandon Yu, Brittany Ma, Lauryn Bailey, Abdul Rab Razzak, Thomas J Smith, Joann N Bodurtha

Research output: Contribution to journalArticle

Abstract

Background: Hereditary cancer assessment and communication about family history risks can be critical for surviving relatives. Palliative care (PC) is often the last set of providers before death. Methods: We replicated a prior study of the prevalence of hereditary cancer risk among patients with cancer receiving PC consultations, assessed the history in the electronic medical record (EMR), and explored patients’ attitudes toward discussions about family history. This study was conducted at an academic urban hospital between June 2016 and March 2017. Results: The average age of the 75 adult patients with cancer was 60 years, 49 (55%) male and 49 (65%) white. A total of 19 (25%) patients had no clear documentation of family history in the EMR, sometimes because no family history was included in the admission template or an automatically imported template lacked content. In all, 24 (32%) patients had high-risk pedigrees that merited referral to genetic services. And, 48 (64%) patients thought that PC was an appropriate venue to discuss the implications of family history. The mean comfort level in addressing these questions was high. Conclusions: At an academic center, 25% of patients had no family history documented in the EMR. And, 32% of pedigrees warranted referral to genetic services, which was rarely documented. There is substantial room for quality improvement for oncologists and PC specialists—often the last set of providers—to address family cancer risk before death and to increase use and ease of documenting family history in the EMR. Addressing cancer family history could enhance prevention, especially among high-risk families.

Original languageEnglish (US)
JournalAmerican Journal of Hospice and Palliative Medicine
DOIs
StateAccepted/In press - Jan 1 2018

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Neoplasms
Electronic Health Records
Palliative Care
Genetic Services
Referral and Consultation
Pedigree
Palliative Medicine
Urban Hospitals
Quality Improvement
Documentation
Cross-Sectional Studies
History
Communication

Keywords

  • cancer
  • electronic health record
  • family history
  • genetic referral
  • genetic risk
  • palliative care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Role of Palliative Medicine in Assessing Hereditary Cancer Risk. / Abusamaan, Mohammed S.; Quillin, John Martin; Owodunni, Oluwafemi; Emidio, Oluwabunmi; Kang, In Guk; Yu, Brandon; Ma, Brittany; Bailey, Lauryn; Razzak, Abdul Rab; Smith, Thomas J; Bodurtha, Joann N.

In: American Journal of Hospice and Palliative Medicine, 01.01.2018.

Research output: Contribution to journalArticle

Abusamaan, Mohammed S. ; Quillin, John Martin ; Owodunni, Oluwafemi ; Emidio, Oluwabunmi ; Kang, In Guk ; Yu, Brandon ; Ma, Brittany ; Bailey, Lauryn ; Razzak, Abdul Rab ; Smith, Thomas J ; Bodurtha, Joann N. / The Role of Palliative Medicine in Assessing Hereditary Cancer Risk. In: American Journal of Hospice and Palliative Medicine. 2018.
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abstract = "Background: Hereditary cancer assessment and communication about family history risks can be critical for surviving relatives. Palliative care (PC) is often the last set of providers before death. Methods: We replicated a prior study of the prevalence of hereditary cancer risk among patients with cancer receiving PC consultations, assessed the history in the electronic medical record (EMR), and explored patients’ attitudes toward discussions about family history. This study was conducted at an academic urban hospital between June 2016 and March 2017. Results: The average age of the 75 adult patients with cancer was 60 years, 49 (55{\%}) male and 49 (65{\%}) white. A total of 19 (25{\%}) patients had no clear documentation of family history in the EMR, sometimes because no family history was included in the admission template or an automatically imported template lacked content. In all, 24 (32{\%}) patients had high-risk pedigrees that merited referral to genetic services. And, 48 (64{\%}) patients thought that PC was an appropriate venue to discuss the implications of family history. The mean comfort level in addressing these questions was high. Conclusions: At an academic center, 25{\%} of patients had no family history documented in the EMR. And, 32{\%} of pedigrees warranted referral to genetic services, which was rarely documented. There is substantial room for quality improvement for oncologists and PC specialists—often the last set of providers—to address family cancer risk before death and to increase use and ease of documenting family history in the EMR. Addressing cancer family history could enhance prevention, especially among high-risk families.",
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