Is there cancer in your family?

We are starting a research study named CHARM (Cancer Health Assessments Reaching Many). Some people don’t know about or don’t use medical care related to cancer that runs in families. This causes differences in health between groups of people. The purpose of this study is to learn how to lower those differences in health.

The first step is to answer questions about whether you or your family members have had cancer.

By answering these questions, you may learn that your family tree has more cancer (for example, breast, ovarian, or colon cancer) than average, which means you may be at higher risk for cancer. If this happens, we will tell you and we will recommend you follow up with your doctor. We will also offer you genetic testing using saliva (spit) through this research study. Genetic testing finds changes in DNA that cause diseases that run in families.

Answering these questions is not a genetic test and the questions do not include all types of cancers that run in families. That means that our questions miss some people that have cancer in their family. A benefit of completing these questions is that you may learn about ways to change your medical care to find or treat cancer earlier.

It is voluntary to answer these questions. You can stop at any time. You can also talk to your doctor about your family history of cancer instead of answering the questions.

We may share your answers with your doctor and put them in your medical record, especially if they could help your doctor take care of you. We may also contact you.

Kaiser Permanente and Denver Health commit to protect your health information. Federal laws also protect your privacy. People inside and outside of Kaiser Permanente Northwest and Denver Health may need to see your personal health information for this study, including from your medical record. This information may be shared to help learn about cancer in families and to help your doctor with your medical care. Some of the individuals who might view this information include your doctor, research partners, people who review the safety of research, and funders of the study. By answering these questions, you agree to let us use and share your personal health information.

The information we will share includes the answers to these questions which may be placed in your medical record. If you are not comfortable with us sharing your information, you should not answer these questions. Answering these questions will document your authorization. This authorization will not expire, unless you contact us in writing.

Please answer these questions as best as you can, even if you don’t know all the answers to all the questions. Please think carefully about your answers before moving to the next page because you can’t go back. We expect it may take 10-20 minutes to answer all of the questions. If you agree to answer these questions, please select “I agree” next.

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