What’s right for one person may not be right for someone else. Here’s what to know about hereditary cancer screening, inherited cancer risk, and how to determine what’s right for you.

If a parent or other member of your family has been diagnosed with cancer, what does that mean for you? Is there a chance that you could get the same cancer, or a different cancer? 

First, it's important to note that not all cancers are inherited. In fact, most cancers are not. Only about 5%-10% of cancer cases are associated with a genetic change (variant) passed down by a biological parent. Also, some people with cancer-related inherited variants never get cancer. So, when someone has an inherited genetic variant, it can increase their cancer risk, but it doesn’t mean they will definitely get cancer.1,2

But how do you know if you have a genetic predisposition to cancer? 

While genetic testing is not always recommended, there are steps you can take to become more informed and empowered. Certified genetic counselor Madison LaFleur answers common questions about genetic testing for hereditary cancer to help you understand your options and where you can go from here.

What is genetic testing for hereditary cancer?

 

Madison: Genetic testing for hereditary cancer analyzes a patient’s DNA to identify variants associated with an increased risk of certain cancers. Testing is performed using a blood or saliva sample. Genetic testing can help people understand their cancer risk and make informed decisions about their health, such as increased surveillance or preventive measures. It can also inform family members about their potential risks. 

 

How can genetic testing be helpful?

 

Madison: Genetic testing for hereditary cancer is a powerful tool that can offer insights for managing and understanding cancer risk, enabling a more personalized approach to healthcare. It allows for early cancer risk identification, empowering individuals to adopt proactive health measures. These measures may include increased surveillance (using screening tools to monitor and detect any changes over time) or preventative strategies.* 

For people who are already diagnosed with cancer, genetic testing may inform treatment decisions. For example, certain drugs might be more effective for cancers due to specific genetic variants. 

Finally, because hereditary cancer genetic variants are passed down through families, testing one family member can provide valuable information for relatives, enabling them to take preventive actions and improve overall family health and awareness.

*Editor’s Note: Some people who face a high-risk genetic predisposition to cancer choose to control or reduce their risk through preventive strategies such as chemoprevention or risk-reducing surgery such as mastectomy or hysterectomy. 
 

 

Should I get tested for cancer if it runs in my family? 

 

Madison: Genetic testing for hereditary cancer syndromes should be considered if you answer yes to any these questions: 

• Do you have a personal or family history of cancer diagnosed at age 50 or younger? 
• Have you or a relative received multiple cancer diagnoses?
• Are there 2 or more instances of the same or related cancers on the same side of your family, with at least one diagnosis occurring before age 50?
• Are there 3 or more instances of the same or related cancers on the same side of your family? 
• Do you have a personal or family history of rare cancers, such as male breast cancer, triple negative breast cancer, ovarian cancer, pancreatic cancer, metastatic prostate cancer, sarcomas, and/or 10 or more colon polyps at any age?
• Do you have a family member with a known cancer genetic variant? 

While genetic testing for hereditary cancer offers valuable insights, it is important to consider its emotional, psychological, and financial impact. Consulting with a genetic counselor can help patients make informed decisions about whether genetic testing is right for them. 
 

Are You a Previvor?

Previvors are people who are living with an inherited mutation, a family history of cancer, or another factor that increases their risk of developing cancer. Previvors can manage their cancer risk in different ways, including through lifestyle changes, enhanced screening, and surgery.3 

 

Which should happen first: genetic testing, or genetic counseling? 

 

Madison: While not always mandatory, beginning with genetic counseling is often recommended. Genetic counselors provide information, support, and guidance about genetic conditions and testing. Their main objectives are to assess patient risk, explain the genetic testing process, discuss potential implications, and help patients make informed decisions. 

Once testing is ordered and results are available, genetic counselors aid in interpreting results and follow-up planning. Starting with genetic counseling allows patients to approach genetic testing with confidence and a clear understanding of its benefits and limitations.

 

How do I get genetic counseling and testing for hereditary cancer?

 

Madison: If you're considering genetic counseling and testing for hereditary cancer, you can begin by consulting with your primary care physician or OB-GYN, who can refer you to a genetic counselor or a specialized clinic. Alternatively, you can search for a local genetic counselor.

Once you’ve met with a genetic counselor, and if you decide to proceed with testing, they will then assist with test coordination, sample collection, results interpretation, and follow-up planning. 
 

How much does genetic testing for hereditary cancer cost?

 

Madison: The cost of genetic testing for hereditary cancer can vary depending on the complexity of the test, the specific genes analyzed, indications for testing, and insurance coverage. 

Many health insurance plans may cover genetic testing if certain criteria, such as having a personal or family history of cancer, are met. If you don’t have health insurance or if your insurance plan does not cover genetic testing, consider financial assistance programs offered by testing companies, grants from nonprofit organizations, or payment plans to make testing more affordable.