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Abstract
Data
has demonstrated that family history questionnaires (FHQs) are an
invaluable tool for assessing familial cancer risk and triaging patients
for genetic counseling services. Despite their benefits, return rates
of mailed FHQs from newly referred patients remain low, suggesting
potential barriers to their use. To investigate this, a total of 461
participants, 239 who completed a FHQ (responders) and 222 who did not
(non-responders), were surveyed at a subsequent appointment regarding
potential barriers and motivators to using the FHQ. With respective
rates of 51 and 56 %, there was no significant difference in the
proportion of responders and non-responders who reported difficulty in
completing the FHQ; however, for both groups factors related to family
dynamics (large family size, lack of contact with relatives, and lack of
knowledge of family history) were reported as major variables
confounding completion of the FHQ. Responders were also significantly
more likely to have a personal diagnosis of cancer (p = 0.02) and to
report that their physician had discussed the reason for the appointment
with them (p = 0.01). Overall, 19 % of non-responders returned their
FHQ after being mailed an appointment letter and 67 % attended their
scheduled genetic counseling appointment. These findings demonstrate
that difficulty completing the FHQ is not inherent to its design but due
to difficulty accessing one's family history, and that mailed
appointment letters are a highly successful way to increase attendance
rates in the non-responder population. Furthermore, these results
demonstrate the important role that referring physicians play in the
utilization of genetic counseling services.
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