【文章內(nèi)容簡(jiǎn)介】 ? 40 X (bila t e ral) 50 (2nd p rimar y can be o v e r 50) ? 1 (first de gre e) (m a le) An y ag e ? 2 (one 1st d egre e) Averag e age und er 6 0 ? 3 (or mo re) An y ag e ? OV A RI A N C A N CER F A M ILIE S BR E A S T amp。 O V A RI A N C A N CER F A M ILIE S Numb e r of c los e re l a tiv e s a ff e c ted b y o v a ria n c a nce r A c tion Numb e r of c los e re l a tiv e s a ff e c ted b y e ithe r bre a s t or o v a ria n c a n c e r Refe r to FH c li nic 1 No scree n ing req u ir e d 1 both brea st an d o v a rian c ancer ? 2 o r more Ref e r to FH cli n ic 1 male breas t can c er and 1 ov a rian c an cer ? K ey 1 breas t an d 1 o v a rian can cer (o ne 1s t degree) ? G r ee n i s l ow r i sk N o act i on r e q ui r ed 3 or mor e breast a nd/or o varian canc er at an y a ge ? O r an g e i s m od era t e o r hi g h r i s k R ef e r t o FH cl i ni c W hat t o d o if a pat ie nt has a fa mil y hi sto r y of Breast/ O v aria n Cancer ? A clo se rela tiv e is a n y f ir st o r sec o n d d e g ree rela tiv e (pa ren t, b rot h e r , siste r, ch il d , a u n t, u n c le, g ran d p a ren t). P lea se rem e m b e r i f t h e re a re in te rv e n ing m a le rela tiv e s t h e n m o re d ista n t re lat ion sh ips may b e rele v a n t. ? T h e f a m il y h isto ry sh o u ld b e o f a ff e cte d bloo d re la tiv e s t h ro u g h e it her t h e ma tern a l or p a terna l s ide o f t h e fa m il y . ? If t h e re is Je w ish a n c e stry in t h e f a m il y , th e h isto ry m a y b e more sig n if ic a n t – se e k a d v ice fro m t h e Cli n ical Ge ne t ic s se rv ice. ? Ref e r a ff e cte d p a tie n ts a n d clo se fe m a le rel a t iv e s. ? For e nquirie s a b o u t a p a tie n t’s f a m il y h isto ry y o u ca n co n ta c t th e Ca n ce r Fa m il y Histo r y S e rvi ce t e l: 0 1 3 3 2 7 8 5 7 7 1 o r 7 8 8 5 5 5 o r th e Cl inica l Ge n e tic s S e rv ice o n : 0 1 1 5 9 6 2 7 7 2 8 Supporting Geics Education for Health Familial Colorectal Cancer ? Colorectal cancer mon – 1 in 25 ? 510% strong geic contribution ? The most important of these geic syndromes are: familial adenomatous polyposis(FAP) Lynch Syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC) ? Most dominant – not all! Case 3 73 52 Peter 75 60s 78 73 63 77 35 died in war 68 Colorectal cancer Supporting Geics Education for Health Case 3 73 52 Peter 75 60s 78 73 63 77 35 died in war 68 Colorectal cancer Low risk –reassure advise on symptom awareness and reporting. FOB testing from 60y. Supporting Geics Education for Health Case 4 73 40 Peter 75 60s 78 73 43 77 35 died in war 68 Colorectal cancer Supporting Geics Education for Health Case 4 73 40 Peter 75 60s 78 73 43 77 35 died in war 68 Colorectal cancer Refer –moderate risk ?Young age of onset (under 45) Refer –to Familial Cancer Service Royal Derby Hospital. 1st degree relatives offered bowel screening. Tumour investigations may be possible to clarify condition. Case 5 Colorectal cancer Endometrial cancer 80 75 69 55 78 48 42 Gee 49 42 30 Martin 39 Polyps Supporting Geics Education for Health Case 5 Colorectal cancer Endometrial cancer 80 75 69 55 78 48 42 Gee 49 42 30 Martin 39 Polyps Refer –high risk ?Young age of onset ?Endometrial and bowel cancers (other related cancers include ovarian, ureteric, renal pelvis, gastric) ?Two generations ?Polyps Refer to Wendy Chorley diagnoses would be confirmed, offer geic testing to Gee. Bowel screening would be offered to atrisk family members. K e y G r ee n i s l ow r i sk O r an g e i s m od era t e r i s k P i nk i s m od e r ate t o hi g h r i sk R ed i s hi g h r i s k N u mb er o f c l o se r el at i v es w i th b o w e l can ce r A g e o f can cer d i a g n o si s R efer to F H cl i n i c 1(1st degree) 50 ? 50 x 1 (1st de gree) Separat e or m ultipl e tumours at an y age ? 1 (1st de gree poly ps on ly ) More th an on e sig nifi cant (1 0mm) pol y p under 5 0 y rs ? Averag