Are you female?	Yes	No
Do you have a family history of breast and/or ovarian cancer?	Yes	No
Are you over the age of 18?	Yes	No
Do you have at least one first-degree relative (mother, sister, or daughter) with breast or ovarian cancer?	Yes	No

If you answered yes to all of these questions, you may be at increased risk of developing breast or ovarian cancer.

If you are a woman past menopause, you may be eligible to participate in a breast cancer prevention study cancer prevention study.

Prostate Cancer

Are you male?	Yes	No
Are you African-American?	Yes	No
Do you have a family history of prostate cancer??	Yes	No
Do you have one first-degree relative (father, brother or son) with prostate cancer??	Yes	No
Was your relative diagnosed at a young age?	Yes	No

If you answered yes to most of these questions, or if you are an African American male, you may be at increased risk of developing prostate cancer.

If you are a man over 55 (African American man over 50), you may be eligible to participate in a prostate cancer prevention study.

Skin Cancer (Melanoma)

Do you have one or more first-degree relatives (parent, brother, sister, child) with a history of melanoma??	Yes	No
Do you experience severe blistering sunburns (especially at young ages)??	Yes	No
Do you sit in the sun with the purpose of getting tan, use tanning lamps or tanning booths??	Yes	No
Do you have red or blond hair and fair skin that freckles or sunburns easily?	Yes	No

If you answered yes to any of these questions, you may be at risk of developing skin cancer (melanoma).

Liver Cancer

Have you been diagnosed with hepatitis-B virus (HBV) hepatitis C virus (HCV)?	Yes	No
Do you drink large amounts of alcohol?	Yes	No
Have you been diagnosed with cirrhosis of the liver (a progressive disorder that leads to scarring of the liver)?	Yes	No

If you answered yes to any of these questions, you may be at risk of developing liver cancer.

Gastrointestinal Cancer

Do you or one of your close relatives have a history of colorectal cancer, colon polyps or other cancers (uterine, stomach, bile duct, urinary tract or ovarian?	Yes	No
Were you previously treated for colon cancer or polyps??	Yes	No
Do you have inflammatory bowel disease, such as ulcerative colitis or Crohn's disease?	Yes	No
Have you consumed foods that contain aflatoxins? Aflatoxins are a group of chemicals produced by a mold that can contaminate certain foods, such as peanuts, corn, grains, and seeds, and are carcinogens (cancer causing agents) for liver cancer.	Yes	No

If you answered yes to one or more of these questions, you may be at risk of developing gastrointestinal cancer.

If you would like more information, or if you would like to talk to a nurse regarding your answers to the above questions, please call 1-888-FOX CHASE (1-888-369-2427).

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