You Can Help Your Family Doctor Save Lives

Approximately a quarter of women have an increased risk of carrying an inherited mutation in a gene that raises their cancer risk. Unfortunately, many doctors are not trained to assess hereditary cancer risk, and up to 90% of high-risk women remain unidentified. FORCE (Facing Our Risk of Cancer Empowered), a national nonprofit organization for individuals and families facing hereditary cancer, wants to significantly improve that percentage.

Hereditary cancer risk assessment is an essential component of comprehensive women’s health care. Risk assessments can identify women who have an increased likelihood of breast, ovarian and other hereditary cancers and are most likely to benefit from genetic testing.

Identifying high-risk women is crucial for implementing personalized medical management, such as advanced or earlier screening, surveillance, or risk-reducing surgery or medication that reduces mortality. For example, national expert guidelines recommend annual breast MRI screening beginning at age 25 (or earlier based on youngest age of breast cancer in the family) for women at high risk due to an inherited BRCA gene mutation.

Your Primary Care Provider May Be Part of the Solution and a Key to Saving Lives

The broad scope and continuity of care provided by family medicine doctors can be pivotal for women’s health. Since family physicians often serve as the first point of contact, their ability to recognize subtle warning signs for hereditary cancer risk and provide appropriate referrals for genetic counseling can save lives. Yet many of these dedicated doctors aren’t equipped to discuss or identify these signs. In fact, the personal and family cancer history of many women is not assessed by their health care providers until after a cancer diagnosis. That’s why FORCE developed an initiative to change that dynamic.

Many family doctors are board-certified by the American Board of Family Medicine (ABFM). This credential reflects a provider’s commitment to a higher standard of patient care. Like other health organizations, the ABFM uses Performance Improvement Activities (PIAs) to enhance physician skills and improve patient care and outcomes. PIAs equip physicians with the most current evidence-based health guidelines while placing patient voices and values at the center of care. Physicians who use the PIAs also earn credits toward ABFM Certification requirements.

A Performance Improvement Activity for Hereditary Cancer

A PIA developed by FORCE and approved by the ABFM helps family physicians quickly and reliably identify patients who may be at risk for hereditary cancer. Consisting of five distinct components, the framework empowers family health professionals to deliver optimal, compassionate care to at-risk patients.

• Risk assessment: Outlines how to take detailed personal and family histories that help patients understand their risk. Hearing patients’ concerns and thoughtfully considering their histories reassures patients and fosters trust in their care team.
• Genetic counseling and testing: Highlights the importance of referring patients for genetic counseling, where they can discuss genetic testing in a supportive environment. Many women feel empowered after learning about their testing options and implications, regardless of the results.
• Management strategies: Encourages physician-patient collaboration to tailor surveillance and prevention based on individual risk. Enhanced screening, chemoprevention and risk-reducing surgery are explored together, balancing medical recommendations and patient preferences. Women value shared decision-making that respects their autonomy and answers their questions.
• Patient education: Guides crucial communication about genetic risks and available interventions, while prioritizing emotional support and acknowledging the psychological impact of hereditary cancer risk. Patients appreciate honest, open discussions that help them understand their choices and reduce fear.
• Documentation and follow-up: Recommends follow-up appointments to provide an ongoing relationship of support and care that encourages patients to voice concerns, ask questions and adjust risk-management plans as their needs evolve.

Physician and Patient Benefits

The PIA tool enhances clinical competency in genetics and risk management. It also helps to cultivate trust and open communication with patients. With expanded expertise, family medicine doctors are better prepared to address sensitive topics, guide informed decisions, and deliver comprehensive care that meets the medical and emotional needs of women at risk.

Physicians who use the hereditary cancer PIA demonstrate a commitment to lifelong learning, professional growth and the highest standards of patient-centered care — qualities that distinguish family physicians as advocates for their patients and leaders within their communities. As one physician reported: “This is something we will definitely continue, and I am happy to have such good resources to review and share with patients. It was a great learning experience, and I hope more family physicians decide to do it, too.”

Paying It Forward: You Can Make a Difference

For many of us, learning that we have a family history or genetic predisposition to cancer is a stressful, life-altering experience. The knowledge of increased risk can bring anxiety but also awareness and motivation to take proactive steps. When doctors are equipped with the latest information in genetics and risk management, patients have confidence that we are receiving the most up-to-date advice and support. Our questions and concerns are addressed more thoroughly, and we know our choices are respected and understood.

As a patient who has faced the uncertainty and anxiety of hereditary cancer risk, I truly value the compassionate partnership I have with my family doctor. It means the world to me to know my doctor is always striving to learn, grow and support me — not just as a patient, but as a person. I have already encouraged my family doctor to utilize the ABFM PIA because it fosters a genuine commitment to my well-being.

It’s reassuring to have a family medicine clinic that recognizes subtle signs, guides us to appropriate genetic counseling, and helps me navigate our options for screening, prevention and emotional support. I want my doctor to feel empowered to talk openly about risks, answer my questions honestly and help me make decisions that fit my values and hopes for the future.

I’m sure you want the same for yourself and your family members who share your hereditary risk. I’m sharing my experience with you, in hopes you’ll help yourself and others by sharing the PIA opportunity with your family doctor.

Together, and with a proactive, caring and informed approach from our primary care providers, we can navigate uncertainty with confidence, resilience and hope for a healthier future.

Piri L. Welcsh, Ph.D., is the vice president of education at FORCE.