# Impact of family history and decision support on high-risk cancer screening

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2020 · —

## Abstract

DESCRIPTION (provided by applicant):    
Anticipated impact on veterans' healthcare. The Veterans Health Administration (VA) has no system-wide, comprehensive, validated method for assessing family health history (FHH) or providing decision support. A standardized FHH assessment accompanied by decision support facilitates 3 important objectives: 1) identification of patients at higher risk, 2) genetic consultation referral for patients at risk for hereditary cancer syndromes, and 3) recommendation of guideline-based preventive care for patients of all risk levels. Receipt of appropriate preventive care will help prevent, or at least improve early detection of, deadly diseases, improving lives of thousands of Veterans and reducing health care costs to the VA healthcare system. Project background. Although FHH is commonly accepted as an important risk factor for common, chronic diseases, it is rarely used in clinical practice as part of a structured risk assessment .To facilitate use of FHH in primary care, the Genomic Medicine Model (GMM) was developed. The GMM 1) provides education to physicians, patients, and communities on the importance of FHH; 2) contains a health IT-based platform (MeTree) that uses patient-entered data to risk-stratify patients and generate risk-stratified, evidence-based preventive care recommendations for physicians and patients; and 3) provides resources to patients and providers to effectively interpret FHH information and adhere to recommendations. Collection of FHH to inform preventive care for colorectal cancer (CRC) in VA is important because patients at higher risk for CRC are not well-characterized or documented in VA and high-risk versus average-risk prevention strategies currently are not systematically assessed or measured. Project objectives. The goal of this study is to evaluate the feasibility and effectiveness of the GMM for identifying patients at increased risk for CRC. This goal will be achieved in a 4-year mixed methods study with the following aims: Aim 1: Determine whether FHH collection via MeTree improves identification of patients at higher familial risk for CRC by comparing rates of high-risk identification in the medical record prior to study enrollment to rate of high-risk identification following MeTree completion. Aim 2: Evaluate whether providing decision support to patients and PCPs improves risk-appropriate PCP referrals for, and patient uptake of, CRC screening/surveillance. Aim 3: Assess experience with decision support and effects on workflow from PCPs, and obtain information to inform eventual implementation in the VA healthcare system from administrative leaders, via qualitative interviews. Aim 4: Conduct cost-consequence and budget-impact analyses of implementing FHH collection and GMM decision support in VA. Project methods. Eligible patients are aged 40-65 years, enrolled in primary care, do not have a personal history of CRC, and have some knowledge of FHH. In Aim 1, a retrospectiv...

## Key facts

- **NIH application ID:** 10178092
- **Project number:** 5I01HX001082-05
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Corrine Ione Voils
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2014-10-01 → 2020-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178092

## Citation

> US National Institutes of Health, RePORTER application 10178092, Impact of family history and decision support on high-risk cancer screening (5I01HX001082-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10178092. Licensed CC0.

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