TY  - JOUR
T1  - Cost of Family History Clinic in a District General Hospital
AU - , A.R. Carmichael AU - , R. Boparai AU - , I. Street AU - , G. Ninkovic 
JO  - Surgery Journal
VL  - 1
IS  - 2
SP  - 39
EP  - 42
PY  - 2006
DA  - 2001/08/19
SN  - 1816-3211
DO  - sjour.2006.39.42
UR  - https://makhillpublications.co/view-article.php?doi=sjour.2006.39.42
KW  - Breast neoplasms
KW  -mammography
KW  -risk assessment
KW  -family
KW  -female
KW  -genetic screening
KW  -genetics
KW  -human mutation
AB  - The aim of this study was to review the financial costs of the Family History Clinic (FHC) in a Distric General Hospital (DGH), which offered women at moderate to high risk of familial breast cancer risk assessment, regular clinical and radiological screening according to local guidelines and protocols. The clinical record of all the patients attending a FHC in a DGH were reviewed for patient characteristics, strength of family history, number and cost of clinical visits, radiological and cytological examinations. The 79 patients in the family history follow-up clinic 32 (41%) were high risk, 46 (58%) were moderate risk and in one patient (1%) the clinical records were incomplete.  The mean Claus score lifetime risk of familial cancer was 26(9).  At a mean follow up of 4 years and after an expenditure of £68,225, only one mammographically occult grade II, node positive (3/16) interval cancer was detected in a woman from the high-risk group; no cancer was detected at the prevalent or incidental screening round. The average (standard deviation) outpatient cost of the FHC per patient was £870 (480).  The  average  cost  of  attendance  at  a  family  history  clinic  was  approximately  £218/  patient/year. Significant clinical and radiological resources used to run a FHC in a DGH failed to yield early detection of breast cancer in a cohort of moderate and high-risk patients.  The provision of a service of FHC outside Clinical Trial settings is difficult to justify.
ER  -