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Frequently Asked Questions

Learn more about cancer risk assessments, genetic testing for cancer, and more at UPMC Hillman's Cancer Genetics Program.

People want to know their cancer risk for many reasons.

The most common are to:

  • Learn the risk of cancer for themselves, their children, or other family members.
  • Find out if genes played a role in their cancer diagnosis or that of a family member.
  • Learn if they should have cancer screenings, such as mammograms or colonoscopies, at a younger age than most people.
  • Help them decide if they should use medical options like hormone replacement therapy or preventive surgery to manage their higher cancer risk.
  • Learn if genetic (DNA) testing would be useful for finding cancer-predisposing genes.

Having an inherited risk does not mean you have gotten a cancer diagnosis.

It means that you were born with changes to your DNA that may increase your chance of getting certain cancers.

Changes in certain genes may cause hereditary cancers. Parents may pass these genes to children, which may increase the risk of one or more types of cancer.

But not everyone who inherits the changed gene will get cancer. Most cancers happen by chance in people with no family history of that cancer (these cancers are not hereditary).

Around 5% to 10% of all cancers are "inherited" or "hereditary."

Some people are more at risk of cancer than others.

This risk is higher in people whose families have one or more of the following:

  • Two or more people on the same side of the family have the same type of cancer.
  • Someone received a cancer diagnosis at age 50 or younger.
  • Someone had cancer in paired organs, such as both breasts or both eyes.
  • Someone had a very rare cancer, such as male breast cancer.
  • Someone has more than one type of cancer (e.g., both colon and uterine cancer, or both breast and ovarian cancer).
  • People from two or more generations (on one side of the family) had the same or a related type of cancer.
  • People from certain ethnic backgrounds. (For instance, people of Ashkenazi Jewish ancestry are at higher risk for changes in the BRCA1 or BRCA2 genes.)

A cancer risk consult provides:

  • Details on how inherited and environmental factors may cause cancer in a family or person.
  • Correct information about a person's cancer risk.
  • Facts about cancer screening and DNA testing.

Learning this may relieve anxiety, provide a sense of control, and play a role in staying in good health.

At your first visit — which takes about 1 to 1 1/2 hours — you'll meet with a doctor who focuses on gene health. You'll also meet with a genetic counselor.

They will fully review your family and medical histories. This includes the types of cancer and the age of diagnosis.

After finding your main concern, the consult team will provide:

  • An estimate of your risks for certain cancers based on your age, family history, and other factors.
  • A complete analysis of your family tree and the possible role of genetics in your family's cancer.
  • Suggested cancer screening tests you should have and how often you should have them.

They'll also discuss:

  • The types of cancers we can find with a DNA test.
  • The pros and cons of genetic testing.
  • What you can do when you get the results, and how those results may make you feel.
  • Any emotional issues about cancer and risk.
  • Insurance coverage and confidentiality.

The discussion will help you decide if DNA testing is right for you.

No. You can self-refer to the Cancer Genetics Program.

Or, you can have any health care provider refer you.

To make an appointment or refer a patient, call the Cancer Genetics Program at 1-800-454-8156.

Our office is open Monday through Friday, from 8:30 a.m. to 4:30 p.m. Nights and weekends, you can leave a message.

Some insurance plans will cover all or part of a consult and genetic test as an outpatient visit.

Because each insurer differs and may change coverage terms over time, we suggest that you check with your plan directly.

We're happy to give you procedure codes and anything else to help you find out your plan will cover our services.

Feel free to call the Cancer Genetics Program at 1-800-454-8156.

Yes. To get genetic testing you must first see a certified or credentialed genetics counselor.

It's part of the DNA testing process and necessary so you understand your test results.

No.

Genetic counseling is a form of education and risk assessment based on your family and your own medical history. It will help you learn your cancer risk based on your DNA.

After counseling, you can decide if you do or don't want to proceed with genetic testing.

A complete family tree is one of the most crucial pieces. It helps us learn if the type of cancer in your family is due to an inherited tendency. It also helps us assess your overall risk of cancer.

When you make an appointment for a cancer risk consult, we'll ask who in your family has had cancer.

We'd like data on three to four generations of family members. Reach as far back as great-grandparents and forward to include children and later generations.

We'll also ask if you're okay with getting written consent for your relatives' medical records for us to review.

Before your visit, we'll fill out and send you a medical records release form with instructions for each of your relatives.

During the first visit, we'll ask you many questions about your family — including those who've had cancer and those who haven't.

For relatives who have had cancer, we will want to know:

  • Who they are.
  • How old they were when they received a cancer diagnosis.
  • Where in the body the cancer started (which organ).
  • If they're living or deceased.

For living relatives who have not had cancer, we will want to know:

  • Their current ages.
  • About their health conditions.
  • If they have had any surgeries.

For deceased relatives who did not have cancer, we will want to know:

  • How old they were when they passed away.
  • Their cause of death.
  • If they had serious health problems during their lifetimes.

We know many people may not have all the answers to these questions. It may be a good idea to talk to older family members before you schedule a consult.

We will still see you, even if you don't know much about your relatives' health status or can't get their medical records.

In most cases, you'll only need one visit. It's enough for us to give you details on the role genetics plays in your family's cancer and your risk of cancer.

We might need a second visit to get more details about your relatives so we can give a complete cancer risk assessment. You can make this appointment once you have all the information we need.

In cases where genetic testing seems helpful, we will:

  • Test you after your complete cancer risk assessment.
  • Get your informed consent before drawing any blood for DNA testing.
  • Discuss your genetic test results at a later time.

Once you have a consult, you may find it helpful to see other doctors to learn about preventive surgery. You may also want to seek counseling to help cope with the worry cancer risk may cause.

We work very closely with all cancer specialists.

As a team, we can provide people at high risk for cancer with the most advanced data on screenings and risk management.

Yes.

We welcome you to bring a support person — such as your spouse or partner — to your first cancer risk visit. In fact, we urge you to bring a loved one since we focus on family history and your medical history in detail.

If some issues in your history are private and not known to your loved ones, you may want to come alone.

Any person concerned about his or her family or personal history of cancer can find value in a risk assessment.

But we do find cancer risk consults are especially helpful for:

  • People who have several first-degree relatives — parents, sisters, brothers, children — with cancer.
  • Families that have two or more relatives on the same side of the family with the same or related types of cancers.
  • People who have had, or whose relatives have had:
    • Cancer that occurred at an early age — before 50 — such as breast, ovarian, or colon cancer.
    • Primary cancers in both breasts, ovaries, kidneys, or adrenal glands.
    • Two different primary cancers — such as breast and ovarian cancers, breast and colon cancers, or uterine and colon cancers.
    • A rare form of cancer — such as male breast cancer, retinoblastoma, medullary thyroid cancer, or sarcoma.
    • An inherited health problem where cancer occurs more often than in those without the condition. These include conditions such as multiple intestinal polyposis, neurofibromatosis, or Cowden disease.
    • A known altered, cancer-predisposing gene.

All of the records from your visit to the program are private.

We keep some records in a private, locked office, while others are part of the secure electronic record.

If your doctor refers you, we'll send them a consult letter and your test results.

Please note: insurance companies can access your records for billing.