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Low accuracy of self-reported family history of melanoma in high-risk patients

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Abstract

Family history of melanoma is a major melanoma risk factor. However, self-reported family histories for some cancers, including melanoma, are commonly inaccurate. We used a unique database, the Utah Population Database (UPDB), as well as the Utah Cancer Registry to determine the accuracy of self-reported family history of melanoma in a large cohort of high-risk patients. Patient charts were reviewed and compared to records in the UPDB and the UCR to confirm personal and family history of melanoma in 1780 patients enrolled in a total body photography monitoring program. Self-reported family history of melanoma in first-degree relatives had an overall sensitivity of 71%, specificity of 79%, PPV of 31%, and NPV of 95%, with decreased accuracy (PPV) for second-degree relatives. A personal history of melanoma was the only factor significantly associated with accuracy in self-reported family history of melanoma. Patient age, sex, estimated nevus count, and number of prior personal melanomas were not significant predictors. Dermatologists should educate patients on the differences between melanomas, keratinocyte carcinomas, and pre-cancers. Confirming self-reported family history of melanoma may improve risk assessment for patients undergoing screening.

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Abbreviations

CI:

Confidence interval

CRC:

Colorectal cancer

FHx:

Family history

HNPCC:

Hereditary nonpolyposis colorectal cancer

KC:

Keratinocyte carcinoma

NPV:

Negative predictive value

PPV:

Positive predictive value

TBP:

Total body photography

UCR:

Utah Cancer Registry

UPDB:

Utah Population Database

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Acknowledgements

We gratefully acknowledge the assistance of Jennifer West with IRB approval and Yuan Wan for facilitating use of the UPDB and the UCR.

Funding

A.M.S. was supported by a Dermatology Foundation Public Health Career Development Award. D.G. was supported by the University of Utah Department of Dermatology and the Huntsman Cancer Foundation (HCF). The Utah Cancer Registry is funded by the National Cancer Institute (NCI)’s SEER Program (#HHSN261201800016I), the U.S. Center for Disease Control and Prevention's National Program of Cancer Registries, (#NU58DP0063200-01), with additional support from the University of Utah and HCF. We thank the Pedigree and Population Resource at HCI (funded in part by the HCF) for its role in the ongoing collection, maintenance and support of the UPDB. We also acknowledge partial support for the UPDB through grant P30 CA2014 from the NCI, University of Utah, and the University of Utah’s Program in Personalized Health and Center for Clinical and Translational Science.

Author information

Authors and Affiliations

  1. School of Medicine, University of Utah, Salt Lake City, UT, USA

    Nicholas D. Flint, Michael D. Bishop & Jennifer L. Strunck

  2. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    Tristan C. Smart, Kenneth M. Boucher & Douglas Grossman

  3. Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA

    Kenneth M. Boucher

  4. Department of Dermatology, University of Utah, Salt Lake City, UT, USA

    Douglas Grossman & Aaron M. Secrest

  5. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA

    Aaron M. Secrest

  6. Department of Dermatology, University of Utah, 30 N 1900 East, 4A330, Salt Lake City, UT, 84132, USA

    Aaron M. Secrest

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  1. Nicholas D. Flint
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  2. Michael D. Bishop
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  5. Kenneth M. Boucher
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  6. Douglas Grossman
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  7. Aaron M. Secrest
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Corresponding author

Correspondence to Aaron M. Secrest.

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Conflict of interest

Dr. Grossman received honoraria for serving on the Advisory Board of Orlucent, Inc. Dr. Secrest, Mr. Bishop, Mr. Flint, Ms. Smart, Ms. Strunck, and Dr. Boucher have no conflicts of interest to disclose.

Ethics approval

The University of Utah Institutional Review Board approved this study (#101237).

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Flint, N.D., Bishop, M.D., Smart, T.C. et al. Low accuracy of self-reported family history of melanoma in high-risk patients. Familial Cancer 20, 41–48 (2021). https://doi.org/10.1007/s10689-020-00187-0

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