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Have you ever been diagnosed with cancer or rare tumor?
(Please note: if you’ve had basal or squamous cell skin cancers and no others, you can say “No” to this question)
Do you live in any of the following states: Connecticut, Delaware, Florida, New Jersey, New York or Pennsylvania?
Why are we asking this?
Depending on where you live, we can recommend services available to you at MSK.

It’s you time

Some broad questions about you. These should be easy.
  • About you
  • Your day-to-day
  • Your health
  • Your family history
  • Your screening history
Why are we asking this?
Many screening recommendations are based on age.
I am years old.
What sex were you assigned at birth?
Why are we asking this?
Screening recommendations are generally based on biological differences. If you’d rather not share what sex you were assigned at birth, we’ll give you general recommendations instead.
Why are we asking this?
Keeping your body at a healthy weight will help lower your risk of getting cancer.
I weigh pounds
How tall are you?
I am feet and
inches tall
Why are we asking this?
Keeping your body at a healthy weight will help lower your risk of getting cancer. Knowing your height will help us assess this.
What is your race/ethnicity?
Select all that apply.
Why are we asking this?
Your race can affect your risk level for certain cancers. For example, Black and African American men are at higher risk for prostate cancer.

What’s your day like?

We’re curious about your lifestyle and habits.
  • About you
  • Your day-to-day
  • Your health
  • Your family history
  • Your screening history
How often do you wear sun protection?
We’re talking sunscreen, sunglasses, and protective clothing.
Why are we asking this?
Sunscreen can protect your skin against harmful rays of the sun that cause cancer.
Have you ever used a tanning bed, booth, or sun lamp?
Why are we asking this?
Tanning beds, booths, and lamps raise your chance of getting skin cancer.
In an average week, how much do you exercise?
We mean physical activity that’s moderate (you can comfortably have a conversation without feeling out of breath) to high-intensity (it’s hard to have a conversation).
Why are we asking this?
Exercising regularly can help you keep a healthy weight, immune system, and hormone levels, and can also help with inflammation.
On an average day, how many cups of fruits and vegetables do you eat?
For context, 1 cup is the size of a tennis ball.
Why are we asking this?
Fruits and vegetables can help protect you against some chronic diseases, such as cancer.
In an average week, how many days do you eat red or processed meat?
We’re talking about beef, lamb, or pork; charred meat; or processed meats (such as deli meats, bacon, or hot dogs).
Why are we asking this?
Eating red meat and processed meat has been linked to several types of cancer.
How often do you drink alcohol?
Why are we asking this?
Drinking alcohol has been linked to several types of cancers.
Do you smoke cigarettes?
Why are we asking this?
Smoking cigarettes can increase your risk for several types of cancers, especially lung cancer.

How about your health?

Let’s take a deeper dive into your health history. Just a few more questions.
  • About you
  • Your day-to-day
  • Your health
  • Your family history
  • Your screening history
Do you have any of the following?
Select all that apply.
Why are we asking this?
Anyone can get skin cancer. But some factors can increase your risk.
Have you had any of these inflammatory bowel diseases for more than 8 years?
Select all that apply.
Why are we asking this?
Inflammatory bowel diseases can raise your risk for colon cancer. You may need regular screenings.
Have you ever been diagnosed with 10 or more colon polyps?
Why are we asking this?
Certain types of polyps in your colon or rectum may increase your risk for colorectal cancer. If you’ve had 10 or more polyps, specifically adenomas (also referred to as pre-cancerous polyps), you might want to consider genetic testing.

How’s your family?

We’d like to hear about those you’re related to by blood. It’s okay if you don’t know all the answers, just do the best you can.
  • About you
  • Your day-to-day
  • Your health
  • Your family history
  • Your screening history
Are any of your biological grandparents of Ashkenazi (Eastern European) Jewish descent?
Why are we asking this?
Individuals of Ashkenazi Jewish descent are at increased risk for certain genetic mutations associated with specific cancers.
Have any of your blood relatives been diagnosed with a gene mutation linked to cancer?
For example, BRCA1/BRCA2, CHEK2, ATM, and Lynch syndrome
Blood relatives = parents, siblings, half-siblings, children, aunts, uncles, nieces, nephews , & grandparents.
Why are we asking this?
Certain genetic mutations (changes in your genes) are associated with an increased risk of developing specific cancers. Knowing your family history will determine if you might be an appropriate candidate for genetic testing.
Have any of your blood relatives been diagnosed with cancer?
Blood relatives = parents, siblings, half-siblings, children, aunts, uncles, nieces, nephews , & grandparents.
Why are we asking this?
Knowing your family history will help us determine which types of screenings you might need.

You’re almost done.

One question about screenings.
  • About you
  • Your day-to-day
  • Your health
  • Your family history
  • Your screening history
Last question. What cancer screenings have you had?
Select all that apply.
Why are we asking this?
Screenings can help find cancer when it’s at an early stage and easier to treat. We’re really big fans of screenings because they save lives. We hope you’ll be, too.

You did it

We have all the answers we need from you. Now it’s our turn to share recommended screenings and times.

Start over
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