[EDITORIAL NOTE]{.underline}: This module was part of a questionnaire
associated with a melanoma study. If you are studying a different
cancer, you may want to skip or alter H8-H10, H27-H29.

**SECTION H. FAMILY HISTORY**

Now I have a few questions about the health of some of your
[blood]{.underline} relatives. I am only interested in your relatives
who are related by blood. Do not include adopted or foster relatives. I
will be asking about your mother, your father, any sisters and brothers
you have, and any children.

H1. First, are you adopted?

YES 1

NO 2 (H3)

H2. Can you answer questions about the health of your
[blood]{.underline} relatives, that is your birth-parents or any
brothers or sisters?

YES 1

NO 2 (H21)

H3. Are you a twin (or triplet)?

YES 1

NO 2 (H5)

H4. Are you an identical or fraternal twin (or triplet)?

IDENTICAL 1

FRATERNAL 2

Now I will ask a few questions about the health of your blood relatives.
Let\'s start with your mother.

> (ASK H5-H16 FOR EACH RELATIVE.)

+-------+---------+---------+---------+---------+---------+---------+
|       | H5.     | H6.     | H7.     | H8.     | H9.     | H10.    |
|       |         |         |         |         |         |         |
|       | Is your | Is what | How old | Did     | Was it  | How old |
|       | R       | year    | (is     | your    | a       | was (he |
|       | ELATIVE | did (he | your    | R       | me      | / she)  |
|       | alive   | / she)  | R       | ELATIVE | lanoma? | when it |
|       | now?    | die?    | ELATIVE | ever    |         | was     |
|       |         |         | now/was | have    |         | dia     |
|       |         |         | your    | skin    |         | gnosed? |
|       |         |         | R       | cancer? |         |         |
|       |         |         | ELATIVE |         |         |         |
|       |         |         | when he |         |         |         |
|       |         |         | / she   |         |         |         |
|       |         |         | died?   |         |         |         |
+-------+---------+---------+---------+---------+---------+---------+
| a\.   | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
| M     | ..      | _\|\_\_ | |\_\_\| | ...1    | ....... | |\_\_\| |
| other | .1(H7a) | \|\_\_\ |         |         | 1       |         |
|       |         | |\_\_\| | AGE     | NO .. 2 |         | AGE     |
|       | NO .... |         |         | (H11a)  | NO      |         |
|       | 2       | YEAR    |         |         | .       |         |
|       |         |         |         |         | ....... |         |
|       |         |         |         |         | 2       |         |
+-------+---------+---------+---------+---------+---------+---------+
| b\.   | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
| F     | ..      | _\|\_\_ | |\_\_\| | ...1    | ....... | |\_\_\| |
| ather | .1(H7b) | \|\_\_\ |         |         | 1       |         |
|       |         | |\_\_\| | AGE     | NO . 2  |         | AGE     |
|       | NO .... |         |         | (H11b)  | NO      |         |
|       | 2       | YEAR    |         |         | .       |         |
|       |         |         |         |         | ....... |         |
|       |         |         |         |         | 2       |         |
+-------+---------+---------+---------+---------+---------+---------+

+-----------+-----------+-----------+-----------+-----------+-----------+
| H11.      | H12.      | H13.      | H14.      | H15.      | H16.      |
|           |           |           |           |           |           |
| Did your  | Where did | How old   | Did your  | Where did | How old   |
| RELATIVE  | the       | was (he / | RELATIVE  | the       | was (he / |
| ever have | cancer    | she) when | ever have | cancer    | she) when |
| any other | start?    | it was    | any other | start?    | it was    |
| cancer?   | (What     | d         | cancer?   | (What     | d         |
|           | type of   | iagnosed? |           | type of   | iagnosed? |
|           | cancer    |           |           | cancer    |           |
|           | did (he / |           |           | did (he / |           |
|           | she)      |           |           | she)      |           |
|           | have?)    |           |           | have?)    |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO .. 2   | \_\_\|\_\ |           | NO .. 2   | \_\_\|\_\ |           |
| (H5b)     | _\|\_\_\| | AGE       | (H5b)     | _\|\_\_\| | AGE       |
|           |           |           |           |           |           |
|           | \_\_\_\_  |           |           | \_\_\_\_  |           |
|           | \_\_\_\_\ |           |           | \_\_\_\_\ |           |
|           | _\_\_\_\_ |           |           | _\_\_\_\_ |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO .. 2   | \_\_\|\_\ |           | NO . 2    | \_\_\|\_\ |           |
| (H17)     | _\|\_\_\| | AGE       | (H17)     | _\|\_\_\| | AGE       |
|           |           |           |           |           |           |
|           | \_\_\_\_  |           |           | \_\_\_\_  |           |
|           | \_\_\_\_\ |           |           | \_\_\_\_\ |           |
|           | _\_\_\_\_ |           |           | _\_\_\_\_ |           |
+-----------+-----------+-----------+-----------+-----------+-----------+

Again, I would like to remind you that I am only interested in your
[blood]{.underline} relatives.

H17. How many full sisters do you have, both living and deceased? (IF
ANY, ENTER \"FULL SISTER\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

FULL SISTERS

H18. How many half sisters do you have, both living and deceased? (IF
ANY, ENTER \"HALF SISTER\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

HALF SISTERS

H19. How many full brothers do you have, both living and deceased? (IF
ANY, ENTER \"FULL BROTHER\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

FULL BROTHERS

H20. How many half brothers do you have, both living and deceased? (IF
ANY, ENTER \"HALF BROTHER\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

HALF BROTHERS

H21. Now I would like to ask about your children. How many daughters do
you have? Be sure to include any who have died. (IF ANY, ENTER
\"DAUGHTER\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

DAUGHTERS

H22. How many sons do you have? Be sure to include any who have died.
(IF ANY, ENTER \"SON\" FOR EACH ONE IN H23.)

\|\_\_\_\|\_\_\_\|

> SONS

(IF ANY ENTRIES IN H23, ASK H24-H35 FOR EACH ONE. PROBE FOR FIRST NAME
OF EACH RELATIVE.)

+---------+---------+---------+---------+---------+---------+---------+
| H23.    | H24.    | H25.    | H26.    | H27.    | H28.    | H29.    |
|         |         |         |         |         |         |         |
| RELAT   | Is your | In what | How old | Did     | Was it  | How old |
| IONSHIP | R       | year    | (is     | your    | a       | was (he |
|         | ELATIVE | did (he | your    | R       | me      | / she)  |
|         |         | / she)  | R       | ELATIVE | lanoma? | when it |
|         | alive   | die?    | ELATIVE | ever    |         | was     |
|         | now?    |         | now/was | have    |         | dia     |
|         |         |         | your    | skin    |         | gnosed? |
|         |         |         | R       | cancer? |         |         |
|         |         |         | ELATIVE |         |         |         |
|         |         |         | when he |         |         |         |
|         |         |         | / she   |         |         |         |
|         |         |         | died)?  |         |         |         |
+---------+---------+---------+---------+---------+---------+---------+
| a\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...     | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | 1(H26a) | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30a)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| b\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26b)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30b)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| c\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26c)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30c)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| d\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26d)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30d)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| e\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26e)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30e)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| f\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26f)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30f)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| g\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26g)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30g)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| h\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26h)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30h)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+
| i\.     | YES     | \|\_\   | \|\_\_\ | YES     | YES     | \|\_\_\ |
|         | ...1    | _\|\_\_ | |\_\_\| | ...1    | ...     | |\_\_\| |
| \_\_\   | (H26i)  | \|\_\_\ |         |         | ....... |         |
| _\_\_\_ |         | |\_\_\| | AGE     | NO ...  | 1       | AGE     |
| \_\_\_\ | NO ...  |         |         | 2       |         |         |
| _\_\_\_ | 2       | YEAR    |         | (H30i)  | NO      |         |
|         |         |         |         |         | ....    |         |
| \|\_\_\ |         |         |         |         | ....... |         |
| |\_\_\| |         |         |         |         | 2       |         |
+---------+---------+---------+---------+---------+---------+---------+

+-----------+-----------+-----------+-----------+-----------+-----------+
| H30.      | H31.      | H32.      | H33.      | H34.      | H35.      |
|           |           |           |           |           |           |
| Did your  | Where did | How old   | Did your  | Where did | How old   |
| RELATIVE  | the       | was (he / | RELATIVE  | the       | was (he / |
| ever any  | cancer    | she) when | ever any  | cancer    | she) when |
| other     | start?    | it was    | other     | start?    | it was    |
| cancer?   | (What     | d         | cancer?   | (What     | d         |
|           | type of   | iagnosed? |           | type of   | iagnosed? |
|           | cancer    |           |           | cancer    |           |
|           | did (he / |           |           | did (he / |           |
|           | she)      |           |           | she)      |           |
|           | have?)    |           |           | have?)    |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24b)    | _\|\_\_\| | AGE       | (H24b)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24c)    | _\|\_\_\| | AGE       | (H24c)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24d)    | _\|\_\_\| | AGE       | (H24d)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24e)    | _\|\_\_\| | AGE       | (H24e)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24f)    | _\|\_\_\| | AGE       | (H24f)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24g)    | _\|\_\_\| | AGE       | (H24g)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24h)    | _\|\_\_\| | AGE       | (H24h)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (H24i)    | _\|\_\_\| | AGE       | (H24i)    | _\|\_\_\| | AGE       |
+-----------+-----------+-----------+-----------+-----------+-----------+
| YES ...1  | \|\_\     | \|\_\     | YES ...1  | \|\_\     | \|\_\     |
|           | _\|\_\_\| | _\|\_\_\| |           | _\|\_\_\| | _\|\_\_\| |
| NO ... 2  | \_\_\|\_\ |           | NO ... 2  | \_\_\|\_\ |           |
| (NEXT     | _\|\_\_\| | AGE       | (NEXT     | _\|\_\_\| | AGE       |
| SECTION)  |           |           | SECTION)  |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+