Protocol - Cancer: Personal and Family History
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.
Specific Instructions
None
Availability
This protocol is freely available; permission not required for use.
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 | Male | Female | Yes | No | <50 | 50-64 | 65+ | Never had cancer | Breast | Ovary | Endometrium | Cervix | Lymphoma | Melanoma | Colon/Rectum | Lung | Prostate | Pancreas | Thyroid | Other | <50 | 50-64 | 65+ | Breast | Ovary | Endometrium | Colon/Rectum | Melanoma | Prostate | Other cancer | ||||||
| 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 | ||||||||||||||||||||||||||||||||||||
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| 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
Lifestage
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.
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
Chinese, English
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Logical Observation Identifiers Names and Codes (LOINC) | Cancer pers family hx proto | 62569-9 | LOINC |
| Human Phenotype Ontology | Neoplasm | HP:0002664 | HPO |
| caDSR Form | PhenX PX070601 - Cancer Personal And Family History | 5872900 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
The California Teachers Study, Follow Up Survey 4, 2005-2006
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 Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX070601_Child_Age_1 | ||||
| PX070601120300 | Current age or age at death? | Variable Mapping | ||
| PX070601_Child_Age_3 | ||||
| PX070601140300 | Current age or age at death? | N/A | ||
| PX070601_Child_Age_5 | ||||
| PX070601160300 | Current age or age at death? | N/A | ||
| PX070601_Child_Age_7 | ||||
| PX070601180300 | Current age or age at death? | N/A | ||
| PX070601_Child_Alive_2 | ||||
| PX070601130200 | Alive? | N/A | ||
| PX070601_Child_Alive_4 | ||||
| PX070601150200 | Alive? | N/A | ||
| PX070601_Child_Alive_6 | ||||
| PX070601170200 | Alive? | N/A | ||
| PX070601_Child_Ever_Cancer_Diagnosis_2 | ||||
| PX070601130400 | Never had cancer? | N/A | ||
| PX070601_Child_Ever_Cancer_Diagnosis_4 | ||||
| PX070601150400 | Never had cancer? | N/A | ||
| PX070601_Child_Ever_Cancer_Diagnosis_6 | ||||
| PX070601170400 | Never had cancer? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_1 | ||||
| PX070601120500 | First cancer diagnosis? | Variable Mapping | ||
| PX070601_Child_First_Cancer_Diagnosis_3 | ||||
| PX070601140500 | First cancer diagnosis? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_5 | ||||
| PX070601160500 | First cancer diagnosis? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_7 | ||||
| PX070601180500 | First cancer diagnosis? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_Age_2 | ||||
| PX070601130600 | Current age or age at death? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_Age_4 | ||||
| PX070601150600 | Current age or age at death? | N/A | ||
| PX070601_Child_First_Cancer_Diagnosis_Age_6 | ||||
| PX070601170600 | Current age or age at death? | N/A | ||
| PX070601_Child_Gender_1 | ||||
| PX070601120100 | Gender? | Variable Mapping | ||
| PX070601_Child_Gender_3 | ||||
| PX070601140100 | Gender? | N/A | ||
| PX070601_Child_Gender_5 | ||||
| PX070601160100 | Gender? | N/A | ||
| PX070601_Child_Gender_7 | ||||
| PX070601180100 | Gender? | N/A | ||
| PX070601_Child_Second_Cancer_Diagnosis_1 | ||||
| PX070601120700 | Second or other cancer diagnoses? | Variable Mapping | ||
| PX070601_Child_Second_Cancer_Diagnosis_3 | ||||
| PX070601140700 | Second or other cancer diagnoses? | N/A | ||
| PX070601_Child_Second_Cancer_Diagnosis_5 | ||||
| PX070601160700 | Second or other cancer diagnoses? | N/A | ||
| PX070601_Child_Second_Cancer_Diagnosis_7 | ||||
| PX070601180700 | Second or other cancer diagnoses? | N/A | ||
| PX070601_Father_Alive | ||||
| PX070601030200 | Alive? | N/A | ||
| PX070601_Father_Ever_Cancer_Diagnosis | ||||
| PX070601030400 | Never had cancer? | Variable Mapping | ||
| PX070601_Father_First_Cancer_Diagnosis_Age | ||||
| PX070601030600 | Current age or age at death? | Variable Mapping | ||
| PX070601_Mother_Age | ||||
| PX070601020300 | Current age or age at death? | Variable Mapping | ||
| PX070601_Mother_First_Cancer_Diagnosis | ||||
| PX070601020500 | First cancer diagnosis? | Variable Mapping | ||
| PX070601_Mother_Gender | ||||
| PX070601020100 | Gender? | N/A | ||
| PX070601_Mother_Second_Cancer_Diagnosis | ||||
| PX070601020700 | Second or other cancer diagnoses? | Variable Mapping | ||
| PX070601_Self_Alive | ||||
| PX070601010200 | Alive? | N/A | ||
| PX070601_Self_Ever_Cancer_Diagnosis | ||||
| PX070601010400 | Never had cancer? | Variable Mapping | ||
| PX070601_Self_First_Cancer_Diagnosis_Age | ||||
| PX070601010600 | Current age or age at death? | Variable Mapping | ||
| PX070601_Sibling_Age_1 | ||||
| PX070601040300 | Current age or age at death? | Variable Mapping | ||
| PX070601_Sibling_Age_3 | ||||
| PX070601060300 | Current age or age at death? | N/A | ||
| PX070601_Sibling_Age_5 | ||||
| PX070601080300 | Current age or age at death? | N/A | ||
| PX070601_Sibling_Age_7 | ||||
| PX070601100300 | Current age or age at death? | N/A | ||
| PX070601_Sibling_Alive_2 | ||||
| PX070601050200 | Alive? | N/A | ||
| PX070601_Sibling_Alive_4 | ||||
| PX070601070200 | Alive? | N/A | ||
| PX070601_Sibling_Alive_6 | ||||
| PX070601090200 | Alive? | N/A | ||
| PX070601_Sibling_Alive_8 | ||||
| PX070601110200 | Alive? | N/A | ||
| PX070601_Sibling_Ever_Cancer_Diagnosis_2 | ||||
| PX070601050400 | Never had cancer? | N/A | ||
| PX070601_Sibling_Ever_Cancer_Diagnosis_4 | ||||
| PX070601070400 | Never had cancer? | N/A | ||
| PX070601_Sibling_Ever_Cancer_Diagnosis_6 | ||||
| PX070601090400 | Never had cancer? | N/A | ||
| PX070601_Sibling_Ever_Cancer_Diagnosis_8 | ||||
| PX070601110400 | Never had cancer? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_1 | ||||
| PX070601040500 | First cancer diagnosis? | Variable Mapping | ||
| PX070601_Sibling_First_Cancer_Diagnosis_3 | ||||
| PX070601060500 | First cancer diagnosis? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_5 | ||||
| PX070601080500 | First cancer diagnosis? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_7 | ||||
| PX070601100500 | First cancer diagnosis? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_Age_2 | ||||
| PX070601050600 | Current age or age at death? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_Age_4 | ||||
| PX070601070600 | Current age or age at death? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_Age_6 | ||||
| PX070601090600 | Current age or age at death? | N/A | ||
| PX070601_Sibling_First_Cancer_Diagnosis_Age_8 | ||||
| PX070601110600 | Current age or age at death? | N/A | ||
| PX070601_Sibling_Gender_1 | ||||
| PX070601040100 | Gender? | Variable Mapping | ||
| PX070601_Sibling_Gender_3 | ||||
| PX070601060100 | Gender? | N/A | ||
| PX070601_Sibling_Gender_5 | ||||
| PX070601080100 | Gender? | N/A | ||
| PX070601_Sibling_Gender_7 | ||||
| PX070601100100 | Gender? | N/A | ||
| PX070601_Sibling_Second_Cancer_Diagnosis_1 | ||||
| PX070601040700 | Second or other cancer diagnoses? | Variable Mapping | ||
| PX070601_Sibling_Second_Cancer_Diagnosis_3 | ||||
| PX070601060700 | Second or other cancer diagnoses? | N/A | ||
| PX070601_Sibling_Second_Cancer_Diagnosis_5 | ||||
| PX070601080700 | Second or other cancer diagnoses? | N/A | ||
| PX070601_Sibling_Second_Cancer_Diagnosis_7 | ||||
| PX070601100700 | Second or other cancer diagnoses? | N/A | ||
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)
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 70601 | Cancer: Personal and Family History |