CAIHC Uses Family History to Prevent Cancer

The Chief Andrew Isaac Health Center (CAIHC) is using family history to assist patients in reducing their chances of developing colon cancer. CAIHC is identifying relatives of those who have had a history of precancerous colon polyps. This will assist providers in identifying patients who should be screen every 5 years and who may need to begin screening before the recommended age of 40. CAIHC appears to be the first medical facility in Alaska, to push for the development of this type of family tree.

How does CAIHC identify patients who are at high risk? CAIHC staff used the ANMC definition of High Risk, and called only patients who met this criteria & who had a colonoscopy w/in the past 2.5 years. CAIHC inquired if the patient would be willing to complete a family tree, and return it so that CAIHC could ensure that their immediate family members were up to date, and being brought back at the correct interval. Immediate family members include: parents, siblings, and children. Out of 287 qualifying patients, 172 people agreed to participate.

High Risk Definition: Patients with a 1st degree relative diagnosed with adenomatous colon polyps before the age of 60, should begin colonoscopy screening at age 40, or 10 years before the youngest case in the immediate family. Recommended colonoscopy Interval: every 5 years.
Example- If you have a 1st degree relative who was diagnosed w/precancerous polyps at age 45, you should begin colonoscopy screening at age 35, and repeat colonoscopy every 5 years.

How will I be contacted if I am determined to be high risk?
If chart reviewers discover that you are due for colonoscopy, CAIHC will mail a letter explaining your high risk status, and encourage you to make an appointment with your PCP. If you are up to date on your colonoscopy and have the correct repeat interval recommendation, CAIHC will not contact you directly, but will instead document this in your medical chart. This documentation will be important, should colonoscopy screening guidelines be changed.

How does CAIHC keep patient confidentiality with this new process? CAIHC will not specify which relative was diagnosed with adenomatous polyps in the letter, or in your medical record.

Why is screening for high risk patients important? Screening by colonoscopy can prevent colon cancer, by removing the abnormal growths of tissue, before they turn into cancer. This project is especially important, as some of your family members may have been given a 10 year repeat recommendation, when they should actually be rechecked every 5 years.

Will CAIHC be continuing with this project moving forward? At this time, we are evaluating the workload and available staffing resources for continuing the effort. We will also be evaluating how beneficial the project was for our patients, and take this into consideration (ex: number of patients with corrected colonoscopy interval, number of patients who should be screened before age 40, number of patients with multiple 1st degree relatives). We hope that this project proves to be valuable, and want to encourage our health care partners across the state to take on the same interest, so that we can better protect all Alaskans from colon cancer.

What if I’m concerned about my family members, and was not contacted by CAIHC? Since we could only review recent colonoscopy patients, odds are the majority of eligible patients were not contacted. If you are concerned that you may fall into the high risk category (diagnosed with precancerous polyps before the age of 60), please contact Jenni Dewar for assistance (Cancer Prevention Coordinator, CAIHC), 907-451-6682 x 3657.
In closing- We want to say thank you to all the patients who agreed to participate!