Colorectal Cancer Family History Assessment

Abstract

This article describes family history assessment for colorectal cancer in three outpatient gastroenterology units and examines gastroenterology unit nurses' knowledge and attitudes about family history assessments. Eighty-eight colonoscopy records were surveyed, and 16 RNs were interviewed. The medical record documentation was surveyed using a researcher-developed tool to identify type of cancer, age at disease onset, family relationship, and number of family members with cancer. Gastroenterology unit nurses were interviewed to assess knowledge and attitudes about family history assessment regarding colorectal cancer. Findings indicate that limited family history documentation was present in the medical record and that important age-at-disease-onset information was missing in 95% of patients with a family history of colorectal cancer and in 85% of patients with a family history of Lynch syndrome-associated cancers. No documentation was found in any charts about the number of affected relatives within the same family. Inconsistencies in family history documentation within the same medical record were noted, and family history information was found in multiple chart forms. Gastroenterology nurses rated family history as very important but gave a lower rating to personal knowledge about and resources for family history assessment.

Mainstreaming genetics and genomics: a systematic review of the barriers and facilitators for nurses and physicians in secondary and tertiary care

“…Most articles (n=40, 83%) reported both barriers and facilitators, while a small number only reported the facilitators (n=5, 10%) (20)(21)(22)(23)(24) or the barriers (n=3, 6%) (25)(26)(27). Themes were broadly associated with nurses' and physicians' capability (n=44, 92%), opportunity (n=39, 81%) and motivation (n=38 articles, 79%) to integrate genetics into practice (supplementary file 4).…”

“…Knowledge and Skill: 27 articles (56%) explored nurses' and physicians' knowledge of genetics (9, 26, 28-52), while 41 articles (85%) reported on their skills (9, 21-25, 27-35, 37-47, 49-63). While nurses and physicians routinely engaged in discussions about genetics with their patients (22,24,29,31,38,42,47,49,(52)(53)(54)(55)(56), all demonstrated limited understanding of general genetic concepts, and/or concepts relevant to their specialty (26,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Despite knowledge deficits, nurses and physicians did engage in discussions about genetics with their patients (22,24,29,31,38,42,47,49,(52)(53)(54)(55)(56).…”

“…Oncologists and neurologists were most likely to order genetic testing. There were no reports of nurses or physicians from other specialties ordering testing [25,26,39,49,53,59,60,[64][65][66]. Most nurses and physicians had low awareness of genetic tests relevant to their area of practice (28,30,(38)(39)(40)(41)(42)(43).…”

Knowledge and education to inform evidence-based practice in gastrointestinal nursing: a scoping review

“…There are a few studies that highlight gaps in knowledge around screening and GI diseases that suggest problems with initial diagnosis. For example, a mixed methods exploration of American nurses' knowledge regarding colorectal cancer (CRC) by Kelly (2015), found nurses rated their knowledge as low and important diagnostic information was omitted from 95% of their assessments.…”

A Case of Perimenopausal Endometrial Cancer in a Woman with MSH2 Germline Mutation

“…Recording a patient's family history is the first step in the work-up of Lynch syndrome patients. However, recording an accurate family history is often neglected or inconsistent 4,5. It can be challenging to advise patients to proceed with additional testing when they do not have a family history of cancer.…”