The history to be obtained and recorded varies greatly according to:

1. The familiarity of the physician with the patient.

2. The scope of the examination over and beyond cancer.

3. Whether it is an initial or annual visit.

Most of the remarks contained in subsequent paragraphs will assume the first visit of a new patient in the course of an examination designed primarily for cancer detection.

Background data, especially that of a strictly factual variety (age, date, and causes of family deaths, operations, hospitalizations, etc.) may be obtained in several ways:

1. By preprinted, self-administered forms; in other words, a medical questionnaire which the patient fills out at home or while waiting in the office prior to examination.

2. By the physician's medical assistant, nurse, or secretary. Information obtained in this fashion can be recorded directly on the regular form.

3. By the physician himself.

All of the information obtained must be reviewed by the physician, of course, and most details of the system review and similar areas requiring medical insight, guidance, and interpretation must be accomplished by him. Often, however, considerable time can be saved if purely factual data are obtained by others.

It must be emphasized that the history should be very thorough, with emphasis placed on sites and symptoms of high cancer potential.

Forms To Be Used

The exact forms to be used for obtaining and recording information will depend on the following:

1. Whether the examination is to be restricted to a search for cancer and related diseases or to be a general medical survey.

2. Whether the findings are to be written out by the physician or dictated for transcription, i.e., whether the form is to be used as a work sheet for taking notes or as the final chart record, or both.

3. The physician's own preference and convenience.

Various forms are available from the American Cancer Society and many of its local branches, as well as from some state and county medical societies and a number of surgical supply and stationery houses. Representative samples of the forms used at Strang Cancer Prevention Clinic, Memorial Hospital for Cancer and Allied Diseases, are reproduced on pp. 36 to 43. Many doctors prefer to modify their routine office forms to include the items listed below. As long as the records are comprehensive and accurate, no serious objection can be raised to this practice.