The purpose of this toolkit is to provide oncology professionals with the tools and resources that will assist them in effectively integrating hereditary cancer risk assessment into practice.
Approximately 5% to 10% of cancers are attributable to a hereditary cancer predisposition syndrome. Identifying those who have this genetic predisposition has significant implications for surgical treatment, chemotherapy choices, prognosis, subsequent cancer risks for the individual and cancer risk for relatives.
As an accompaniment to the educational opportunities and guidance ASCO offers on hereditary risk assessment and management, this resource has been developed to serve as a repository of tools and resources to assist oncology providers with hereditary risk management within their practices.
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Comments or Questions? Please contact us at Prevention@asco.org
ASCO appreciates the contributions of Marie Wood, Joanne Jeter, and the members of the Genetics Subcommittee and Cancer Prevention Committee in the development of this resource.
The ideas and opinions expressed here do not necessarily reflect the opinions of the American Society of Clinical Oncology (ASCO). The mention of any product, service, or therapy herein should not be construed as an endorsement of the products mentioned. The information herein should not be relied on as being complete or accurate, nor should it be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. The information is not continually updated and may not reflect the most recent evidence. The information addresses only the topics specifically identified therein and is not applicable to other interventions, diseases, or stages of diseases. This information does not mandate any particular course of medical care. Furthermore, the information is not intended to substitute for the independent professional judgment of the treating provider, because the information does not account for individual variation among patients. Use of the information is voluntary. ASCO provides this information on an as-is basis and makes no warranty, express or implied, regarding the information. ASCO specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. Links to third party websites are provided for your convenience, and ASCO does not endorse and is not responsible for any content, advertising or other material available from such sites. ASCO assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions
“The Basics”: Understanding Hereditary Cancer Syndromes
Germline genetic testing can identify an individual’s hereditary risk for a number of cancers, including cancers of the breast, ovary, uterus, colon, stomach, thyroid and other primary sites. The identification of an inherited predisposition can have implications for clinical care, surveillance, chemoprevention, and preventive surgery.
In general only a small proportion of any cancer type is hereditary; defined here as having a risk almost entirely attributable to germline mutations in a single gene. The line between hereditary and familial is not always clear. For common cancers, such as those of the lung, breast, colon, and prostate, less than 10% are hereditary. Another subset (15-25%) may be due to an interaction between multiple genes and the environment and they too can result in cancers clustering in families, but no specific testing is available for these familial cancers. Other less common types of cancer, such as ovarian, uterine, pancreatic, and renal cancers, have a proportion (albeit small) of cancer that is hereditary. Hereditary cancers may be identified by specific characteristics of the individual cancers and characteristics of the family history. Examples of individual characteristics of cancers that have a high likelihood of being hereditary include triple-negative breast cancer and high-grade serous ovarian cancer. Family history can be an important clue to a hereditary form of cancer, and important features of the family history include: cancer in several generations, early age of cancer onset, aggregation of cancer types in a family (such as breast and ovarian or