Abstract A11: Assessment of family cancer history in a pancreatic cancer clinic: A pilot study of a web-based survey
Authors: Schradle Kara Anne , Cameron Heather Gail , Kumar Riya , Koeppe Erika , Leflein Elana , Moisa Cristina , Demerath Matthew , Stoffel Elena Martinez , Simeone Diane M. 
Published: December 2016

Introduction: Approximately 5-10% of pancreatic cancer diagnoses are associated with inherited cancer syndromes and family cancer history assessment is a critical component of identifying these high risk families. We developed and validated a comprehensive web-based family history survey, which collects cancer type and age of diagnosis for first and second degree relatives directly from patients, generating a summary and cancer risk model scores for medical care teams in real-time. We tested feasibility and performance of this tool in an outpatient pancreatic cancer clinic setting.

Methods: 161 patients age 18 years and older, with appointments at the University of Michigan Multidisciplinary Pancreatic Tumor Clinic between September 2015 and February 2016 were approached during their clinic visit to complete the web-based survey on an iPad device. Responses were compared to the clinic’s current family history collection method with medical assistants entering data from paper forms into the electronic medical record (EMR) during the intake process. Data completeness, and proportion of patients identified as meeting criteria for genetic referral were compared between the two survey modalities.

Results: 92.5% of patients approached agreed to take the iPad survey. Time to complete the survey ranged from 2-50 minutes (mean 12 minutes). Patient ages ranged from 24 to 87 years, with a median age of 64. Patients who were unfamiliar with the iPad technology and/or had difficulty recalling ages of diagnoses of relatives accounted for a greater amount of time taken to complete the survey. Only 6.0% of patients were unable to complete the survey prior to the end of their visit. Of the 128 patients that completed the iPad survey, 82 (64.1%) had a personal history of pancreatic cancer; the remaining 46 (35.9%) presented with a personal or family history suggestive of increased pancreatic cancer risk. Based on clinical criteria for genetic referral for known inherited syndromes related to increased pancreatic cancer risk, we determined that 53.7% of patients with a pancreatic cancer diagnosis met criteria for genetic counseling by iPad survey vs 41.4% by the paper form. Of patients without a pancreatic cancer diagnosis, 23.9% met genetic referral criteria using the iPad tool vs 21.7% using the paper form. Among patients with pancreatic cancer, the most common reasons for meeting high risk criteria were having another family member with pancreatic cancer (12.2%) or having two or more relatives on the same side of the family with cancers associated with increased pancreatic cancer risk (e.g., breast, ovarian, melanoma; 17.1%). Among those without a personal history of pancreatic cancer, the most common reasons for meeting high risk criteria were family history of ovarian cancer (6.5%), and having three or more related family members with the aforementioned cancers (13.0%).

Conclusions: Assessment of family history using a web-based tool is feasible, as demonstrated by high participation and completion rates among all age groups. Both iPad and paper surveys identified a significant percentage of patients for genetic referral. Improvements in obtainment of cancer relevant family history and better inclusion of such data in the EMR may play an important role in better screening of high risk individuals for pancreatic and other types of hereditable cancers.

Citation Format: Kara Anne Schradle, Heather Gail Cameron, Riya Kumar, Erika Koeppe, Elana Leflein, Cristina Moisa, Matthew Demerath, Elena Martinez Stoffel, Diane M. Simeone.{Authors}. Assessment of family cancer history in a pancreatic cancer clinic: A pilot study of a web-based survey. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A11.