What is a Cancer Risk Assessment?
A cancer risk assessment is a type of genetic counseling appointment conducted by a genetic counselor or medical geneticist that involves:
- A thorough evaluation of one’s personal and family history of cancer
- An assessment of the likelihood that a gene mutation is the cause of cancer in the family
- A discussion of the risks and benefits of genetic testing
- An explanation of the options for managing an increased risk of cancer
Why Is Family History
Important for Cancer Risk Assessment?
Families affected by a hereditary cancer syndrome may have certain patterns of cancer diagnoses associated with their increased risk for cancer. It is impossible to tell from family history alone whether or not you are at risk for hereditary cancer. However, if you find one or more of the
following in your family health history, meeting with a genetic counselor for a cancer risk assessment may be appropriate:
- Two or more closely related individuals with breast cancer, diagnosed at any age
- Cancer diagnosed at young ages (before 50)
- Multiple cancer diagnoses in one individual (e.g. breast and ovarian, bilateral breast cancer)
- Individuals affected in multiple generations (e.g. grandfather, mother and aunt)
- Rare cancers such as ovarian cancer or male breast cancer
- Two or more family members with the same type of cancer (e.g. breast, ovarian, prostate, uterine, colon or stomach cancers)
- Ashkenazi Jewish ancestry
Need help gathering more information about your family’s cancer history? See our
Family Health History page for some helpful tools and resources.
What are Genetic Counselors?
Genetic counselors provide education and personalized support for individuals and families affected by – or at increased risk for – genetic disorders. They have advanced training in medical genetics and counseling and can: assess risk; help individuals think through the benefits
and drawbacks of genetic testing and make informed decisions; interpret test results; and discuss available options and provide resources. Genetic counseling is essential for all people considering BRCA testing.
What are Medical Geneticists?
Medical geneticists provide similar information and resources, but have expertise as physicians and may also help treat genetic disorders. They are able to provide information from a medical standpoint and provide medical care to an individual or family.
What is Genetic Testing?
Genetic testing is used to identify patients who have genetic mutations that may significantly increase their risk of developing a disease (e.g., cancer) and may benefit from increased cancer surveillance and/or other preventive measures, such as prophylactic surgery. Prior to the
test, a genetic counselor or medical geneticist can discuss the benefits and risks of genetic testing, as well as the implications of positive and negative results and any factors that may influence your decision about whether you want to proceed with testing. This testing may pertain to family planning or personal
health, and may test for either recessive carrier disorders or hereditary types of cancer.
Genetic testing for hereditary cancers involves more than the average blood test because it invokes issues of:
- Test-related anxiety — what will you do with the information?
- Privacy and confidentiality — who has access to the information?
- Genetic discrimination — what are the myths and realities?
- Psychological effects within families — how will your genetic test results affect your family members and how do they feel about you being tested?
Genetics professionals recommend counseling both before and after testing to prepare patients for the test and to help them understand the results that come back.
What are the Benefits of Knowing you Have a Hereditary
Cancer Predisposition Gene?
Genetic testing can help you and your doctor better understand your health risks so that together you can determine a management plan that is right for you. This may include more frequent examinations, blood tests, imaging, or risk-reducing surgeries.
Genetic testing is not right for everyone. For example, some people may find that knowing about a mutation or cancer predisposition causes increased anxiety. A genetic counselor can help you think through the implications of testing and help you make an informed decision. If you decide
not to undergo genetic testing, you may talk to your doctor about whether increased cancer surveillance is appropriate for you.
If you would like to ask a genetic counselor about risk assessment and testing, please contact us.