Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program |
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Authors: | Aimee L Lucas Adam Tarlecki Kellie Van Beck Casey Lipton Arindam RoyChoudhury Elana Levinson Sheila Kumar Wendy K Chung Harold Frucht Jeanine M Genkinger |
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Institution: | 1.Henry D. Janowitz Division of Gastroenterology, Samuel Bronfman Department of Medicine,Icahn School of Medicine at Mount Sinai,New York,USA;2.Department of Epidemiology, Mailman School of Public Health,Columbia University,New York,USA;3.Division of Gastroenterology, Department of Medicine,Columbia University,New York,USA;4.Department of Biostatistics, Mailman School of Public Health,Columbia University,New York,USA;5.Cancer Genetics Program,New York Presbyterian Hospital,New York,USA;6.National Institute of Diabetes and Digestive and Kidney Diseases,National Institutes of Health,Bethesda,USA;7.Division of Molecular Genetics, Department of Pediatrics,Columbia University,New York,USA;8.Herbert Irving Comprehensive Cancer Center,Columbia University,New York,USA |
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Abstract: | Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer death; approximately 5–10% of PDAC is hereditary. Self-administered health history questionnaires (HHQs) may provide a low-cost method to detail family history (FH) of malignancy. Pancreas Center patients were asked to enroll in a registry; 149 with PDAC completed a HHQ which included FH data. Patients with FH of PDAC, or concern for inherited PDAC syndrome, were separately evaluated in a Prevention Program and additionally met with a genetic counselor (GC) to assess PDAC risk (n?=?61). FH obtained through GC and HHQ were compared using Wilcoxon signed-rank sum and generalized linear mixed models with Poisson distribution. Agreement between GC and HHQ risk-assessment was assessed using kappa (κ) statistic. In the Prevention Program, HHQ was as precise in detecting FH of cancer as the GC (all p?>?0.05). GC and HHQ demonstrated substantial agreement in risk-stratification of the Prevention Program cohort (κ?=?0.73, 95% CI 0.59–0.87.) The sensitivity of the HHQ to detect a patient at elevated risk (i.e., moderate- or high-risk) of PDAC, compared to GC, was 82.9% (95% CI 67.3–92.3%) with a specificity of 95% (95% CI 73.1–99.7%). However, seven patients who were classified as average-risk by the HHQ were found to be at an elevated-risk of PDAC by the GC. In the PDAC cohort, 30/149 (20.1%) reported at least one first-degree relative (FDR) with PDAC. The limited sensitivity of the HHQ to detect patients at elevated risk of PDAC in the Prevention Program cohort suggests that a GC adds value in risk-assessment in this population. The HHQ may offer an opportunity to identify high-risk patients in a PDAC population. |
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