GI Genetic Cancer Risk Evaluation

What is cancer risk evaluation?

Cancer Risk Evaluation is the process of determining your personal risk of cancer and is usually based on both your personal medical history and your family's history of cancer. Your physicians then recommend appropriate screening tests to reduce your risk of developing cancer. This evaluation should be part of everyone's routine checkup with their primary care physician. For some people this is not enough. People with blood relatives who have had cancer often may need a more detailed analysis called "Hereditary Cancer Risk Evaluation". This evaluation helps determine both your personal risk for cancer and risks that might extend to your relatives. MNGI's focus is on gastrointestinal cancer with special attention to colorectal cancer.

Cancers that occur because of inherited factors may occur at a younger age and more often than usual. They may need special screening tests and treatments that are different from usual recommendations.

The two major Colon Cancer Genetic Syndromes are Lynch Syndrome (previously known as Hereditary Non Polyposis Colorectal Cancer) and Familial Adenomatous Polyposis. The following internet sites can be helpful to explain these syndromes to you.

• www.nccn.org
• www.invitae.com

What are the steps in Hereditary Cancer Risk Evaluation?

Patients coming to MNGI Digestive Health for clinic visits or procedures who are suspected to have an inherited GI cancer syndrome based on their family history of findings during a procedure (such as large number of colon polyps) would be requested to follow up in the GI Cancer Genetics clinic to discuss different aspects of genetic testing.

A comprehensive GI cancer risk assessment in our GI Cancer Genetics Clinic can give you an idea of whether genetic testing is something that might be important for you and your family. MNGI firmly believes in patient-centered care through informed decision making- you will be able to discuss different aspects of genetic testing and get any questions answered by providers specializing in hereditary cancer risk evaluation. If you decide to proceed with genetic testing, we will order the test and arrange appropriate follow up for you.

Genetic Counselors in the Twin Cities and Greater Minnesota

By system

By Practitioner

Frequently asked questions (FAQs)

Q: If my genetic test does not detect any mutation, does that mean my cancer risk is about the same as anyone else?

A: A negative (normal) genetic test result does not rule out the possibility of an inherited cancer syndrome. Individualized cancer screening recommendations based on your personal and family history is an important part of the discussion.

Q: Should I get my children tested as well?

A: In general terms, genetic testing is not recommended for anyone under the age of 18. However, there are some exceptions depending on certain mutations- therefore results of your genetic test can certainly change those recommendations.

Q: What sample is collected for genetic testing?

A: Either blood (preferred) or saliva-based testing is the standard for genetic testing. However, for individuals with active hematological malignancy (leukemia) or prior allogenic bone marrow transplant, skin punch biopsy is needed for the test. You should inform us about any such history in your case.

Q: Will my insurance cover the cost?

A: In most cases, your insurance should cover the cost of genetic testing. However, you can always check with your insurance provider. Out-of-pocket cost for the most common genetic tests is generally less than $250.

Q: Will this impact my insurance adversely?

A: The Genetic Information Nondiscrimination Act (GINA) - PDF was signed into law on May 21, 2008.  GINA protects individuals against discrimination based on their genetic information in health coverage and in employment.  GINA is divided into two sections, or Titles.  Title I of GINA prohibits discrimination based on genetic information in health coverage.  Title II of GINA prohibits discrimination based on genetic information in employment. However, the law does not cover other forms of insurance such as life-insurance policy (among others). For any related concerns, you should consult your financial advisor or an attorney with knowledge in this area.