GENETICS
First point: Many patients have concerns about a family history of cancer, however less than 5% of cancer is inherited. Even in those rare families where there is an inherited predisposition, unaffected individuals have a greater than 50% chance they will NOT develop an inherited cancer
| Name | Location | Tel | Consider referral in: | How to refer |
| Judith Hayward GPwSI (Bradford) | Judith.Hayward@bradford.nhs.uk
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| Breast Cancer | Yorkshire Regional Genetics Service Ashley Wing St James's University Hospital Beckett St Leeds LS9 7TF |
0113 206 4020
0113 206 6970 |
●≥THREE 1st/2nd degree relatives on the same side of the family with breast Ca at any age ●TWO 1st/2nd degree relatives with breast Ca who were diagnosed approx 50y or less ●ONE 1st degree male relative with breast Ca ●ONE 1st degree relative with breast cancer who: a) diagnosed≤40y b) with two separate breast primaries c) breast and ovarian Ca in same individual ●ONE 1st/2nd degree relative with Breast Ca diagnosed ≤ 60 PLUS 1st/2nd degree relative with any of: ovarian Ca, colon Ca < 50y, leukaemia, pancreatic Ca, sarcoma, thyroid Ca, brain Ca |
●Letter |
| Bowel Cancer | ●FH of known Bowel Ca syndrome eg familial adenomatous polyposis coli (FAP), hereditary non-polyposis colon Ca (HNPCC) ●1st degree relatives of an individual with TWO separate primary bowel cancers or bowel cancer and endometrial, ovarian, stomach, or urinary tract Ca (ureteric or bladder) ●≥ TWO 1st degree relatives on same side of family with bowel Ca ●THREE 1st/2nd degree relatives on the same side of the family with bowel Ca, endometrial, ovarian, stomach or urinary tract Ca ●ONE 1st degree relative with bowel Ca <45y |
Notes
Taking a Family History:
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¨Type of cancer (primary)
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¨Smoking history
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¨Age of onset
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¨If one tumour, or more than one
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¨(Jewish ancestry)
Assessing Risk
Tumour clusters-in families are very unlikely to. have a significant inherited component if :-
i) All different organ sites are involved . Each tumour is likely to have a separate explanation
ii) All tumours have occurred at a late or typical age of onset
iii) All identified tumours have a strong environmental component e.g. smoking or UV light
If there is no evidence of a true family cluster, patients should be reassured but given routine health care advice. It is beneficial to stress the information above in points i-iii and reiterate that 95% of cancer is not inherited even when tumours have occurred within family members. However, individuals will still be at population risk of cancer and should seek advice for unexplained symptoms and participate in national surveillance programmes.
The following' may indicate a greater risk although the majority of patients will still not develop cancer :
i) Multiple family members with tumours at same site
ii)Early age of onset of tumours
iii)A history of individual patients with multiple primary tumours
iv)Recognised association
e.g breast / ovary;
e.g. breast / sarcoma
e.g. colon / endometrial / ovarian / stomach