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Collection of a Cancer Family History

Collection of a cancer family history is crucial to the identification of those individuals who have an inherited predisposition to malignancy or who are at increased risk for additional primary cancers. The goal of the cancer family history is to provide enough information to make a preliminary determination of the risk of a familial predisposition and to develop a preliminary management plan.

The cancer family history should be taken at the first visit with the oncology provider and should be updated periodically. ASCO recommends the minimum adequate family history for cancer patients be defined as family history of cancer in first- and second-degree relatives. First-degree relatives are parents, children, and full siblings; second-degree relatives are grandparents, aunts/uncles, nieces/nephews, grandchildren, and half-siblings. For each relative with cancer, ASCO recommends the following be recorded:

  • Type of primary cancer(s)

  • Age at diagnosis of each primary cancer

  • Lineage (maternal or paternal)
    Patients should be asked if there is a known hereditary cancer predisposition syndrome, prior genetic testing, and for any information regarding ethnicity that may be relevant. Patients with cancer should be specifically asked if they have any Jewish ancestry on either the maternal or paternal side, and if so, a much lower threshold for testing should be adopted. Exploring both maternal and paternal lineage is important, as genetic predisposition can be transmitted from either side of the family. 

See Also: ASCO Statement on Family History Taking in the Oncology Setting (2014)

Additional Tools for Collecting Family History:

Guidelines on Hereditary Risk Assessment & Management 

The guidelines below represent a selection of publicly available resources on genetic testing for specified cancer syndromes; this list is not exhaustive due to restrictions of member-only content. **Inclusion of third-party guidelines and recommendations should not be interpreted as formal endorsement by ASCO.**

Breast and Ovarian Cancer

Gastrointestinal Cancers

Other Topics

Counseling

Medullary Thyroid Cancer

von Hippel-Lindau Syndrome

Content Last Reviewed May 2019

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