Objectives: This systematic review aimed to evaluate, within unselected populations, the:

1. Performance of family history (FHx)-based models in predicting cancer risk.

2. Overall benefits and harms associated with established cancer prevention interventions.

3. Impact of FHx-based risk information on the uptake of preventive interventions.

4. Potential for harms associated with collecting cancer FHx.

Data sources: MEDLINE, EMBASE, CINAHL Cochrane Central, Cochrane Database of Systematic Reviews, and PsycINFO were searched from 1990 to June 2008. Cancer guidelines and recommendations were searched from 2002 forward and systematic reviews from 2003 to June 2008.

Review methods: Standard systematic review methodology was employed. Eligibility criteria included English studies evaluating breast, colorectal, ovarian, or prostate cancers. Study designs were restricted to systematic review, experimental and diagnostic types. Populations were limited to those unselected for cancer risk. Interventions were limited to collection of cancer FHx; primary and/or secondary prevention interventions for breast, colorectal, ovarian, and prostate cancers.

Results:

• Accuracy of models: Seven eligible studies evaluated systems based on the Gail model, and on the Harvard Cancer Risk Index. No evaluations demonstrated more than modest discriminatory