About 10% of many cancers may be related to heredity. Alterations or mutations in genes that can be passed down from generation to generation can provoke an increased risk for some types of cancer. Blood tests are available to determine if you are at greater risk than usual for breast, ovarian, colon, uterine, and other cancers.
If you carry certain mutations in genes known as BRCA 1 or BRCA 2 genes, you may have up to 87% lifetime risk to develop breast cancer as well as up to 44% lifetime risk to develop ovarian cancer. Without the mutation, your lifetime risk for breast cancer is about 8% and for ovarian cancer about 2%. Other gene mutations can increase lifetime risk for colon cancer up to 82% and for uterine cancer up to 71%. For the general population, the lifetime risk for colon or uterine cancer is 1.5% to 2%.
If you or members of your family have any of the following diagnoses, you may be a good candidate for genetic testing, otherwise it’s not advisable.
Breast cancer diagnosed before age 50
Ovarian cancer at any age
Bilateral breast cancer
Both breast and ovarian cancers
Male breast cancer at any age
Ashkenazi/Eastern European descent
Colon/rectal cancer before age 50
Uterine (endometrial) cancer
Several family members with colon cancer
Stomach or ovarian cancer
Someone in your family has been diagnosed with a known genetic mutation that places them at higher than usual risk for cancer.
Genetic testing will not tell you if you have cancer but will tell you the risk of having it.
If you test positive for a mutation, there are successful strategies now in use that can decrease your risk of developing cancer. These options may include taking medications or undergoing preventive surgeries. If you are not willing to take any medication you can at least be monitored closely so that if a cancer does develop, it can be detected early while it is still curable.
The first step is to take a look at your family history. Talk to family members to determine who has had cancer, what type of cancer they had, and how old they were when diagnosed. When referred for genetic testing, your family history will be reviewed to be certain you are a candidate for the test.
So, if you are test positive, you will hear how your test results will help determine if other family members should be tested. Privacy laws will be discussed to assure you that the use of genetic test results cannot be used to determine eligibility or rates of health insurance. (State and Federal laws prohibit health insurance discrimination based on genetic information).
Most insurances cover hereditary cancer risk assessment, with the majority of patients paying a coinsurance of 10% or less. Many patients’ tests are covered 100%.
Even if there is a strong family history of breast, ovarian, colon, or uterine cancer in your family, cancer is not inevitable. Discuss your family history of cancer with your physician at your next appointment.