Cancer Genetic Risk Assessment
Cancer occurs in approximately 1 in 3 individuals during their lifetime. While most cancers are sporadic (occurring by chance), about 5% to 10% of cases are hereditary.
In hereditary cancer, gene mutations (changes) can be passed on from generation to generation. Medical research has identified the genes that cause many of the known hereditary cancer syndromes. Genetic testing may be appropriate to determine if you carry a gene mutation. A person who carries a cancer predisposition gene mutation does not necessarily get cancer but is at higher risk of developing certain cancers.
Our Cancer Genetic Risk Assessment Program works with individuals whose personal medical history and/or family history indicates a possible hereditary cancer syndrome.
- Who Can Benefit from Genetic Counseling?
- What Does Genetic Counseling Involve?
- Genetic Counseling Referral Indications
- Insurance Coverage
Who Can Benefit from Genetic Counseling?
Individuals who may benefit from genetic counseling include:
- Anyone from a family with a known hereditary cancer syndrome
- Anyone with a hereditary cancer syndrome gene mutation who has questions about cancer management options
- Anyone with concerns about developing cancer because of family history
- Anyone considering cancer genetic testing for cancer risk
- Anyone who has had prior genetic testing and would like to further discuss his/her test result
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What Does Genetic Counseling Involve?
Initial genetic counseling consultations last about 60-90 minutes. Follow-up counseling sessions last 30-60 minutes but can vary in length.
During a genetic counseling appointment, your genetic counselor will:
- Review your medical and family history
- Provide individualized risk assessment regarding cancer risk
- Provide genetic education and counseling
- Discuss genetic testing options and facilitate genetic testing for cancer predisposition genes (when appropriate)
- Explain genetic testing outcomes and interpretation (when appropriate)
- Discuss relevant screening recommendations and management options
- Offer guidance to help you make informed decisions
- Provide appropriate referrals (e.g. psychosocial support, physicians) and resources
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Genetic Counseling Referral Indications
We encourage cancer genetic counseling referrals for individuals with a personal and/or family history suggestive of a hereditary cancer syndrome. You can self-refer for a genetics consultation but we strongly recommend that you first speak with your doctor to obtain a referral as some of our recommendations may require your doctor's follow-up care.
Some signs of possible hereditary cancer syndromes include:
- Cancer diagnosed at an unusually young age (e.g. breast or colon cancer before age 50)
- Diagnoses of two or more primary cancers in the same person
- Multiple close family members diagnosed with either the same type of cancer or related cancers
- (e.g. breast and ovarian cancer, colon and uterine cancer)
- Diagnosis of rare cancer or unusual tumors (e.g. male breast cancer)
- Presence of other features associated with an inherited cancer syndrome (e.g. colon polyposis)
Breast and/or Ovarian CancerGenetic counseling is encouraged for individuals with one or more of the following personal/family history:
- Breast cancer diagnosed at or before age 50
- Ovarian cancer at any age (or in a close relative)
- Both breast and ovarian cancer (or in a close relative)
- 2 or more breast primaries (or in a close relative)
- 2 or more cases of breast cancer in close relatives (with at least one diagnosed at or before age 50) from the same side of the family
- 3 or more cases of breast and/or ovarian cancer in close relatives from the same side of the family
- Male breast cancer (or in a close relative)
- Ashkenazi Jewish ancestry AND
- Any of the above
- Breast cancer at any age
- 1 or more cases of breast, ovarian, or pancreatic cancer in close relatives
Colorectal and/or Endometrial CancerGenetic counseling is encouraged for individuals with one or more of the following personal/family history:
- Colorectal cancer diagnosed at or before age 50
- Endometrial cancer diagnosed at or before age 50
- Both colorectal and endometrial cancer (or in a close relative)
- Colorectal or endometrial cancer at any age with a close relative with colorectal or endometral cancer
- Multiple close relatives from the same side of the family with cancers of the colon/rectum, endometrium, stomach, ovary, small bowel, pancreas, and/or urinary tract
- 10 or more colorectal polyps
MelanomaGenetic counseling is encouraged for individuals with one or more of the following personal/family history:
- 3 or more primary melanomas (or in a close relative)
- Both melanoma and pancreatic cancer (or in a close relative)
- 3 or more cases of melanoma and/or pancreatic cancer in close relatives from the same side of the family
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Like other specialty services, genetic counseling and testing is often covered by insurance when it is clinically indicated. However, some insurers have specific requirements about what reasons for testing, or indications, qualify for coverage and in some cases, pre-authorizations may be required. It is important to check with your insurance company about coverage for genetic counseling (CPT Code 96040) to avoid any unexpected out-of-pocket costs. If genetic testing is recommended during your genetic counseling consultation, the genetic counselor will facilitate your testing. The genetic counselor will also work with the testing laboratory and/or insurance provider to determine your level of coverage before genetic testing occurs.
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To schedule an appointment for a cancer genetic consultation, contact us at 415-600-3073. Prior to your appointment we ask that you complete a family history questionnaire and send us relevant medical records in advance so we can prepare for your personalized risk assessment appointment. Once your appointment is scheduled, our Patient Access Center will call you to complete your pre-registration and confirm your insurance coverage.
Cancer Genetic Risk Assessment Program
2351 Clay Street, Suite 134
San Francisco, CA 94115
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