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What is Risk Assessment?
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What is Risk Assessment?
The goal of cancer risk assessment is to assess an individual's level of risk to develop cancer. When a person already has cancer, risk assessment can determine the risk of getting a second cancer. In both cases, the risk assessment process includes collecting family and medical information, meeting with an expert in cancer risk, and when appropriate, having a physical examination and genetic testing. Once the risk assessment is complete, a medical plan proposes ways to lower the risk for cancer or to detect cancer at its earliest stage.
Fox Chase Cancer Center is committed to risk assessment and risk reduction. Since 1991 Fox Chase has offered education, risk assessment, and information about screening, diagnosis, and prevention. The risk assessment includes services for individuals with a family history or personal history of breast and/or ovarian cancer, prostate cancer, colon or other gastrointestinal cancers, melanoma and other skin cancers and other rare cancers. These services offer education and counseling about risk factors, genetic testing and risk reduction options for individuals at risk of developing cancer. The Risk Assessment Services also serves as a research base for ongoing studies of the biological, genetic, and environmental factors that influence disease risk.
Fox Chase Cancer Center provides a full range of medical, nursing, genetic counseling, testing, screening, and research.
What you need for your cancer risk assessment
Steps of Risk Assessment
Education
Every individual who participates in Fox Chase's Risk Assessment Program receives comprehensive education regarding their medical and personal risk factors for cancer, the role genetic factors play in cancer risk, cancer patterns in the family, and the benefits and limitations of genetic testing, where appropriate. Participants also receive information about different screening options and other risk reduction measures based on their individualized risk.
Family History and Risk Evaluations
The Risk Assessment team meets regularly to assign the level of cancer risk and the cancer pattern seen in the family. The team consists of a multidisciplinary group of health care professionals including medical oncologists, genetic counselors, nurses, health educators, and research coordinators. This step helps determine eligibility for genetic testing and/or other research opportunities based on the participant's family history and other medical factors.
Preparation for Genetic Testing
Individuals having genetic testing, receive counseling regarding their genetic risk of cancer, the appropriateness of genetic testing and the risks, benefits and limitations of testing. Participants are also counseled on their eligibility for research or commercial genetic testing. The benefits, risks, and limitations of genetic information on the family are also discussed. Consent is obtained prior to having blood taken for the test.
Learn more about the genetic testing we offer
Receiving genetic test results
During this session, a patient receives their genetic test results from a genetic counselor. A nurse practitioner or physician is also present to review medical management and screening recommendations. Any psychosocial and emotional impact of test results to patients and their family are addressed at this time. A plan may be developed to communicate results to family and medical professionals.
Risk-Reduction and Medical Management
During the individual counseling session and/or follow-up clinic visits, screening and medical management issues are reviewed and resources and referrals provided as needed.
Individualized screening recommendations are offered based on personal medical and family history, clinical and genetic testing findings.
Participants receive an explanation of findings and consideration of options for chemoprevention, screening and surveillance, and risk-reducing surgery if appropriate.
Individuals have the option of receiving medical evaluation and follow-up cancer risk in the new state-of-the-art Prevention Pavilion at Fox Chase Cancer Center. The clinical component includes a comprehensive cancer risk evaluation of personal and medical history along with a physical evaluation. Both the patient and their referring physician will receive information about medical management, screening recommendations, and eligibility for enrolling in current prevention trials.
Medical Risk Assessment
Some women with benign breast biopsies showing lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH), are at a higher risk of breast cancer. The risk may be further increased when there is a positive family history. The clinical service provides patients the opportunity to meet clinicians with special training in breast diseases. Preventive measures such as chemoprevention with Tamoxifen or Raloxifene, other drugs when their role in prevention has been established, or surgery are highlighted during these discussions.
Men with a family history of prostate cancer, having a BRCA mutation or are African American can receive comprehensive evaluation of prostate cancer risk. These men are offered a physical examination and prostate specific antigen (PSA) blood test. Fox Chase Cancer Center utilizes the percent-free PSA blood test for men with a total PSA of1.5 ng/ml as part of its criteria for prostate biopsy. Current literature and PRAP data show that use of the percent free PSA blood test to determine appropriateness of biopsy increases cancer detection and decreases unnecessary biopsies. Men with normal findings on examination and PSA blood test are screened on an annual basis; men with abnormal findings undergo further diagnostic studies (e.g. biopsy, endorectal MRI). The medical examination and the PSA blood test are services that are billed to the participant's health insurance provider.