WMFACS cancer family history surveillance guidelines | Go Back |
Breast Guidelines
Risk should be assessed using manual, IBIS, Boadicea, claus or BRCApro models.
|
Risk Category |
Screening |
Age and Frequency |
| Population | Mammography |
50-70 3yrly, >70 on request |
| Moderate | Mammography |
40-50 Annual 50+ as population |
| High | Mammography |
40-50 Annual 50+ as population |
| Very high |
MRI Mammography |
30-50 Annual 40-50 Annual 50-75 18 monthly, then local protocol |
|
BRCA 1/2 (carriers, 50% risk BRCA1) |
MRI & Mammography Mammography |
30-50 Annual 50-75 18 monthly, then local protocol |
Ovarian guidelines
If risk is >10% age 35-70, or satisfy UKFOCCS criteria, discuss TAHBSO or limitations of screening.
Bowel Guidelines
1 FDR: one affected first degree relative to patient = parent, sibling (brother or sister) or a child
2 FDR: two affected relatives who are first degree to each other. One of the relatives must also be a first-degree relative to the patient. Eg. mother & aunt, mother & sister, father & grandmother etc.
|
Risk Category |
Screening |
Age and Frequency |
|
Population 2 FDR mean age >70 |
FOB test (NBoSP) Colonoscopy |
60-70 2yrly, >70 on request 1 off at 55 if NBoSP unavailable |
|
Moderate - Low 1 FDR <50 or 2 FDR, mean age 60-70 |
Colonoscopy |
Offer IHC+/- MSI to exclude HNPCC (if meet Bethesda) If normal or doesn’t meet Bethesda: 1 off at 55 If meets Bethesda but MSI/IHC not possible: 1 at 35, 1 at 55 |
|
Moderate - High 3 FDR >50 or 2 FDR, mean age <60 |
Colonoscopy |
Offer IHC+/- MSI to exclude HNPCC (if meet Bethesda) If normal: From 50-75, 5yrly If impossible: From 50-75, 5yrly or 35-75, 5yrly if young cases |
|
High Amsterdam positive But MSI/IHC Normal |
Colonoscopy | 35-65 3yrly |
|
HNPCC (carriers or 50% risk) |
Colonoscopy Endometrial TV US/CA125 Urinalysis/Urinary tract US Upper GI Endoscopy |
From 25-75 (or 5 years prior to youngest case in family) 2yrly From 35 annually (or consider TAHBSO) Carriers only From 35 annually (or consider TAHBSO) Carriers only Annual (if urinary tract cancer in family) Carriers only From 50-75, 2yrly (if stomach cancer in family) Carriers only |
| FAP carriers |
Upper GI Endoscopy Colonoscopy |
Discuss lack of evidence for recommended: From 30, 3 yrly From 12 annually until colectomy, continued on rectal stump If at 50% risk of unknown mt: annual 12-30, 3-5yrly 30-40 |
| AFAP carriers | Colonoscopy | From 18 lifelong 2yrly. Annual until colectomy if polyps found |
| MYH homozygotes | Colonoscopy | From 25, 2-3 yrly |
The overall benefit of surveillance outside these guidelines has not been established.
This page was last modified on Fri Mar 18 2011
