Prevention practices and family history of cancer of medical students in the United States

Abstract

Purpose Few studies have examined whether physicians' own family history of cancer influences what they do for their patients or for themselves. To clarify the role of family history in medical students' cancer prevention habits and in patient counseling and screening for cancer, we examined data from the Healthy Doc = Healthy Patient study. Methods To determine basic health practices and status, we surveyed medical students (n = 2,316 individuals responding to ≥ 1 survey) in the Class of 2003 at freshman orientation, entrance to wards, and senior year in a nationally representative sample of 16 medical schools (response rate = 80.3%). Using a checklist in the self-administered questionnaire, the medical students were asked to indicate whether they had a number of health conditions (including colorectal cancer, breast cancer, lung cancer, skin cancer, prostate cancer, or other cancers) now or in the past, or whether a parent, sibling or grandparent had any of the health conditions. They were also asked how relevant they think several prevention activities related to counseling or early detection of cancer will be in their intended practice. The main outcome measures were relevance of prevention counseling to medical students' intended clinical practice (available at all three survey points), and seniors' frequency of counseling typical general medicine patients about cancer prevention. Family history of cancer was measured in relation to each outcome of interest. SUDAAN and logistic regression were used in the analysis, treating each school as a cluster. Results Family history of cancer was generally not significantly related to current counseling or perceived future counseling relevance, though reported family history of skin cancer did increase the odds that a student thought that recommending a clinical skin exam was highly relevant to their intended practice (adjusted OR = 1.56, 95% CI: 1.01, 2.43). Discussion These results suggest that physician family history may influence their patient skin cancer early detection practices but not other preventive practices.