Risk Assessment and Screening Toolkit – Interactive Table of Contents


Chapter 1: Introduction

  • The Value of Family History in Cancer Risk Assessment
  • The Importance of Identifying Colorectal Cancer Family History
  • Early Onset Colorectal Cancer
  • Update on Colorectal Cancer Screening
  • How to Use This Toolkit. Review background about the toolkit development, including its purpose, learning objectives, and intended use.

Chapter 2: Clinical Systems

  • Establish a System for Structured AssessmentReview components of a cancer risk assessment system which includes a standardized process for family history collection and interpretation as well as guidance for developing a personalized management plan for patients.
    • Assembling a Team. Identify core members of the implementation team and engage them in planning sessions.
    • Assessing Your Existing Workflow. Review and describe your existing workflow to identify potential improvements.
    • Setting Goals. Establish your goals and desired outcomes for risk assessment to help you identify the best process and tools for your practice.
  • Planning a Workflow for Family History Collection, Documentation, and Interpretation
    • When to Collect. Figure out when family history should initially be collected and assessed, and how often it should be updated.
    • Where to Document. Choose a documentation method that allows for easy retrieval, assessment and updating, as family history changes over time.
      • Method in Action: Using an Electronic Patient Questionnaire to Collect Cancer Family History. Learn how one practice determined how to implement an electronic family history collection and risk assessment tool in practice.
    • Who Will Collect. Work with your team to determine who will collect the family history: the patient him- or herself, allied health professional, the primary provider, or some combination of the three.
      • Method in Action: Utilizing nurse wellness visits for cancer family history risk assessment. Learn how one practice implemented a nurse-lead cancer risk assessment appointment using a paper-based risk assessment tool.
    • Who Will Interpret. Determine if family history interpretation and risk assessment will solely reside with the primary care provider, or if it will also be aided by other team members and specialists.
    • Identifying Opportunities for Improvement and Defining New Workflow. Identify opportunities to improve your current workflow through incorporation of best practices and integration of a family history tool.
  • Selecting and Evaluating Tools for Collection and Risk Assessment. Select a family history tool that best fits the needs of your practice.
  • Planning Management Protocols for Increased and High Risk Patients
  • Training, Launch, and Evaluation Considerations

Chapter 3: Clinical Skills and Tools for Patient Care

Chapter 4: Key Messages and Limitations of the Toolkit

Chapter 5: Appendix

  • Printable Forms and Worksheets
    • Goals Worksheet. Work through goal setting with stakeholders in the practice.
    • Family History Tool Features Worksheet. Identify family history tools that include desired features and functions.
    • Colorectal Cancer Risk Assessment Checklist. Stratify patients into average, increased, and high risk using a guidelines-based checklist.
    • Simple Family History Screening Tool for CRC. Identify patients who may benefit from genetic referral or increased risk CRC screening using a published patient questionnaire.
    • Accessing Genetic Services Tool. Communicate with patients about a genetic referral and find local genetic professionals.
  • Resources
    • Professional Society Guidelines. Access guidelines about CRC screening for individuals at increased risk of CRC.
    • Provider Education Resources. Access additional education about family history collection, cancer risk assessment, and cancer screening and management.
    • Patient Education Materials. Access patient materials that address family history, cancer risk factors, genetic counseling and genetic testing, CRC screening, and advocacy groups.
    • Best Practices. Review best practices in family history collection and risk assessment in primary care.
  • References

This toolkit was supported by the Grant or Cooperative Agreement Number, DP004969-04, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily rep- resent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.