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Protocol - Cancer: Personal and Family History

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Description:

This protocol is used to assess if the respondent and his or her biological parents, siblings, and children have had cancer. This protocol also obtains information about vital status, age, type of cancer, age at first diagnosis, and any additional cancer diagnoses.

Protocol:

1. Please answer the following questions about you and your "blood" relatives. Do not include adopted, half and step relatives. Please mark all that apply for each person.

       

Alive

Current age or age at death

First cancer diagnosis

Age at first cancer diagnosis

Second or other cancer diagnoses

Relative

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Self

Mother

Father

Sibling #1

Sibling #2

Sibling #3

Sibling #4

Sibling #5

Sibling #6

Sibling #7

Sibling #8

Child #1

Child #2

Child #3

Child #4

Child #5

Child #6

Child #7

Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Life Stage:

Adult

Participants:

Female current and former public school teachers or administrators who participate in the California State Teachers Retirement System (STRS).*

*While this protocol was used in a study of women, the Cancer Working Group deems it appropriate to use with adult males.

Note: This protocol is from a follow-up survey. For respondents who are deceased, a surrogate answered these questions.

Specific Instructions:

None

Selection Rationale

This protocol was selected because it obtains information about personal and family history of cancer in first-degree relatives in a single table. It also obtains vital status and the age at first cancer diagnosis, both of which are critical to assessing cancer risk.

Language

English

Standards
StandardNameIDSource
Common Data Elements (CDE) Person Personal And Family Cancer History Text 2961265 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Cancer pers family hx proto 62569-9 LOINC
Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source
State of California, The California Teachers Study, Follow Up Survey 4, 2005–2006, page 7, question 32 (source for question 1).
General References

None

Protocol ID:

70601

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX070601_Child_Age_1 PX070601120300 Current age or age at death? 4 N/A
PX070601_Child_Age_2 PX070601130300 Current age or age at death? 4 N/A
PX070601_Child_Age_3 PX070601140300 Current age or age at death? 4 N/A
PX070601_Child_Age_4 PX070601150300 Current age or age at death? 4 N/A
PX070601_Child_Age_5 PX070601160300 Current age or age at death? 4 N/A
PX070601_Child_Age_6 PX070601170300 Current age or age at death? 4 N/A
PX070601_Child_Age_7 PX070601180300 Current age or age at death? 4 N/A
PX070601_Child_Alive_1 PX070601120200 Alive? 4 N/A
PX070601_Child_Alive_2 PX070601130200 Alive? 4 N/A
PX070601_Child_Alive_3 PX070601140200 Alive? 4 N/A
PX070601_Child_Alive_4 PX070601150200 Alive? 4 N/A
PX070601_Child_Alive_5 PX070601160200 Alive? 4 N/A
PX070601_Child_Alive_6 PX070601170200 Alive? 4 N/A
PX070601_Child_Alive_7 PX070601180200 Alive? 4 N/A
PX070601_Child_Ever_Cancer_Diagnosis_1 PX070601120400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_2 PX070601130400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_3 PX070601140400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_4 PX070601150400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_5 PX070601160400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_6 PX070601170400 Never had cancer? 4 Variable Mapping
PX070601_Child_Ever_Cancer_Diagnosis_7 PX070601180400 Never had cancer? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_1 PX070601120500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_2 PX070601130500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_3 PX070601140500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_4 PX070601150500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_5 PX070601160500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_6 PX070601170500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_7 PX070601180500 First cancer diagnosis? 4 Variable Mapping
PX070601_Child_First_Cancer_Diagnosis_Age_1 PX070601120600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_2 PX070601130600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_3 PX070601140600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_4 PX070601150600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_5 PX070601160600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_6 PX070601170600 Current age or age at death? 4 N/A
PX070601_Child_First_Cancer_Diagnosis_Age_7 PX070601180600 Current age or age at death? 4 N/A
PX070601_Child_Gender_1 PX070601120100 Gender? 4 N/A
PX070601_Child_Gender_2 PX070601130100 Gender? 4 N/A
PX070601_Child_Gender_3 PX070601140100 Gender? 4 N/A
PX070601_Child_Gender_4 PX070601150100 Gender? 4 N/A
PX070601_Child_Gender_5 PX070601160100 Gender? 4 N/A
PX070601_Child_Gender_6 PX070601170100 Gender? 4 N/A
PX070601_Child_Gender_7 PX070601180100 Gender? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_1 PX070601120700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_2 PX070601130700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_3 PX070601140700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_4 PX070601150700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_5 PX070601160700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_6 PX070601170700 Second or other cancer diagnoses? 4 N/A
PX070601_Child_Second_Cancer_Diagnosis_7 PX070601180700 Second or other cancer diagnoses? 4 N/A
PX070601_Father_Age PX070601030300 Current age or age at death? 4 N/A
PX070601_Father_Alive PX070601030200 Alive? 4 N/A
PX070601_Father_Ever_Cancer_Diagnosis PX070601030400 Never had cancer? 4 Variable Mapping
PX070601_Father_First_Cancer_Diagnosis PX070601030500 First cancer diagnosis? 4 N/A
PX070601_Father_First_Cancer_Diagnosis_Age PX070601030600 Current age or age at death? 4 Variable Mapping
PX070601_Father_Gender PX070601030100 Gender? 4 N/A
PX070601_Father_Second_Cancer_Diagnosis PX070601030700 Second or other cancer diagnoses? 4 N/A
PX070601_Mother_Age PX070601020300 Current age or age at death? 4 N/A
PX070601_Mother_Alive PX070601020200 Alive? 4 N/A
PX070601_Mother_Ever_Cancer_Diagnosis PX070601020400 Never had cancer? 4 Variable Mapping
PX070601_Mother_First_Cancer_Diagnosis PX070601020500 First cancer diagnosis? 4 Variable Mapping
PX070601_Mother_First_Cancer_Diagnosis_Age PX070601020600 Current age or age at death? 4 Variable Mapping
PX070601_Mother_Gender PX070601020100 Gender? 4 N/A
PX070601_Mother_Second_Cancer_Diagnosis PX070601020700 Second or other cancer diagnoses? 4 N/A
PX070601_Self_Age PX070601010300 Current age or age at death? 4 N/A
PX070601_Self_Alive PX070601010200 Alive? 4 N/A
PX070601_Self_Ever_Cancer_Diagnosis PX070601010400 Never had cancer? 4 Variable Mapping
PX070601_Self_First_Cancer_Diagnosis PX070601010500 First cancer diagnosis? 4 N/A
PX070601_Self_First_Cancer_Diagnosis_Age PX070601010600 Current age or age at death? 4 Variable Mapping
PX070601_Self_Gender PX070601010100 Gender? 4 N/A
PX070601_Self_Second_Cancer_Diagnosis PX070601010700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Age_1 PX070601040300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_2 PX070601050300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_3 PX070601060300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_4 PX070601070300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_5 PX070601080300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_6 PX070601090300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_7 PX070601100300 Current age or age at death? 4 N/A
PX070601_Sibling_Age_8 PX070601110300 Current age or age at death? 4 N/A
PX070601_Sibling_Alive_1 PX070601040200 Alive? 4 N/A
PX070601_Sibling_Alive_2 PX070601050200 Alive? 4 N/A
PX070601_Sibling_Alive_3 PX070601060200 Alive? 4 N/A
PX070601_Sibling_Alive_4 PX070601070200 Alive? 4 N/A
PX070601_Sibling_Alive_5 PX070601080200 Alive? 4 N/A
PX070601_Sibling_Alive_6 PX070601090200 Alive? 4 N/A
PX070601_Sibling_Alive_7 PX070601100200 Alive? 4 N/A
PX070601_Sibling_Alive_8 PX070601110200 Alive? 4 N/A
PX070601_Sibling_Ever_Cancer_Diagnosis_1 PX070601040400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_2 PX070601050400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_3 PX070601060400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_4 PX070601070400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_5 PX070601080400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_6 PX070601090400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_7 PX070601100400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_Ever_Cancer_Diagnosis_8 PX070601110400 Never had cancer? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_1 PX070601040500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_2 PX070601050500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_3 PX070601060500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_4 PX070601070500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_5 PX070601080500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_6 PX070601090500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_7 PX070601100500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_8 PX070601110500 First cancer diagnosis? 4 Variable Mapping
PX070601_Sibling_First_Cancer_Diagnosis_Age_1 PX070601040600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_2 PX070601050600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_3 PX070601060600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_4 PX070601070600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_5 PX070601080600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_6 PX070601090600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_7 PX070601100600 Current age or age at death? 4 N/A
PX070601_Sibling_First_Cancer_Diagnosis_Age_8 PX070601110600 Current age or age at death? 4 N/A
PX070601_Sibling_Gender_1 PX070601040100 Gender? 4 N/A
PX070601_Sibling_Gender_2 PX070601050100 Gender? 4 N/A
PX070601_Sibling_Gender_3 PX070601060100 Gender? 4 N/A
PX070601_Sibling_Gender_4 PX070601070100 Gender? 4 N/A
PX070601_Sibling_Gender_5 PX070601080100 Gender? 4 N/A
PX070601_Sibling_Gender_6 PX070601090100 Gender? 4 N/A
PX070601_Sibling_Gender_7 PX070601100100 Gender? 4 N/A
PX070601_Sibling_Gender_8 PX070601110100 Gender? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_1 PX070601040700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_2 PX070601050700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_3 PX070601060700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_4 PX070601070700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_5 PX070601080700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_6 PX070601090700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_7 PX070601100700 Second or other cancer diagnoses? 4 N/A
PX070601_Sibling_Second_Cancer_Diagnosis_8 PX070601110700 Second or other cancer diagnoses? 4 N/A
Research Domain Information
Measure Name:

Cancer: Personal and Family History

Release Date:

December 30, 2009

Definition

Measure to assess if respondent and his or her biological parents, siblings, and children have had cancer

Purpose

Personal and family history is used to assess the presence and age of onset of cancer in all first-degree, biological relatives. A positive family history of cancer in a first-degree relative (parent, siblings, or children) is a cancer-specific risk factor.

Keywords

cancer, personal history, family history, breast, ovary, endometrium, cervix, lymphoma, melanoma, colon, rectum, lung, prostate, pancreas, thyroid, diagnosis, California Teachers Study (CTS)