Most people who get cancer do not have a family history of the disease, which is one reason screening is so important—but a personal or family history of cancer or certain other diseases may increase your risk.
To help determine your risk, complete this family medical history chart and share it with your health care professional and other family members.
This information will help you and your health care provider decide which cancer screenings you need, when to begin screening and how often you should be screened.
Genetic testing may be an option for those who want more information about their cancer risk. Predictive genetic testing is performed to look for specific changes, called mutations, in a person’s genes before they show signs of a disease. One of the most well-known genetic mutations in cancer is found in the BRCA1 or BRCA2 gene. Mutations found in one of these genes can lead to an increased risk of breast and ovarian cancers, or less commonly, cancers of the prostate, fallopian tube or pancreas. In addition to BRCA gene mutations, there are many other types of mutations that can be identified through genetic testing and are linked to hereditary cancer syndromes.
Please note that the following information applies to predictive genetic testing only; this is different from tumor profiling (also known as genomic, biomarker or molecular profiling), which is done after a cancer diagnosis to determine mutations that may affect how the patient responds to certain treatments.
Predictive genetic testing is available for several types of cancers and should be based upon your personal and family medical history. Genetic testing includes, but is not limited to, testing for mutations that increase risk for breast, ovarian, colorectal, prostate and pancreatic cancers. However, even if you test negative for these mutations, you could still be at risk for developing cancer, like others in the general population. Only 5-10 percent of cancer cases are caused by hereditary gene mutations.
If you are considering genetic testing, you should first meet with a genetic counselor or health care professional with expertise in cancer genetics. Genetic counseling is an important part of genetic testing due to the complexities involved. They will discuss the full picture of your health and risk factors (including family history), the pros and cons of genetic testing, implications of potential test results (including the psychological risks and benefits) and your options after you complete testing. You should check with your insurance company before meeting with a genetic counselor or health care professional to see if the meeting and/or genetic testing are covered by your insurance.
Please note that genetic testing—regardless of the result—does not take the place of regular cancer screenings. If you are found to possess a genetic mutation that increases your risk of developing cancer, you may need to undergo more frequent cancer screening or testing.
Exercise caution when considering broad-based genetic testing, or simultaneously testing for hundreds of diseases. This type of testing is not individualized based on family history and personal risk, and will surely pick up mutations for which risk is not known or nothing can be done, which can result in more harm than good for the patient. This is different than multigene panel testing, which is a type of genetic testing that is performed to look for mutations in several genes at one time. These panels may be recommended to you if you are at risk of a hereditary cancer syndrome that has more than one gene associated with it and are based upon your personal and family medical history.
The right not to know:
If you are considering genetic testing, you might also want to share this information with your family members. Gene mutations are hereditary, and some of your family members likely share similar or identical risk factors. We encourage you to discuss this topic with your family and help make them aware of their options; however, you must understand if your family members come to a different decision than you in regards to pursuing genetic testing. It is a decision between individuals, their health care providers and genetic counselors. Everyone has the right not to know about his or her genetic mutations.
If you are adopted or estranged from your family, you might have limited or no knowledge of your family history. Talk to your genetic counselor or health care provider about any family history you are aware of and your race/ethnicity to see if genetic testing makes sense for you. You should also always inform your health care provider if you are adopted.