So, what is hereditary cancer? So, in all, we think that about 5-10% of all cancer is hereditary, meaning that it's caused by a single gene change that's passing through the family and putting people at a higher risk for cancer. Some types of cancer are more likely to be hereditary than others, and some of those are breast cancer, ovarian cancer, colon cancer, prostate cancer, pancreatic cancer, and others. Others are less likely to be hereditary, such as lung cancer or cervical cancer.
The first thing a genetic counselor does is to collect the family history, and we put that into a big family tree. Then we look at that to determine if there are certain patterns to suggest that there could be a hereditary cancer condition. We like to look at about three generations, but we do know that some people have more family history information than others, and some really don't have any at all because of adoption or other circumstances, and we can work with that as well.
But, once we've gathered that information, then we look for certain clues and patterns within the family. Some of those are things like multiple generations of people with the same or related types of cancer, particularly when any of those cancers are occurring at an early age, which we consider under the age of 50.
We also look for individuals who have had cancer more than once, and we're looking for independent cancer, someone that has had more than one independent cancer. So, not just a cancer that has recurred or spread from one organ to another, but cancer that has happened twice. For example, breast cancer in both breasts or someone that has developed colon cancer, and then later uterine cancer.
We also look to see if there are any individuals who have any rare cancers, like a male with breast cancer. The more of these clues that are present, the more likely it is that there could be a hereditary cancer condition in the family. And then, in addition to these family history clues, there are also certain situations where guidelines recommend genetic testing for someone, regardless of the family history.
Our guidelines now say that anyone with pancreatic cancer, anyone with ovarian cancer, anyone with prostate cancer that is high grade or more aggressive or metastatic, those individuals should be offered genetic testing, regardless of family history. The same can be said for anyone who has had breast cancer under the age of 50 or colon cancer under the age of 50.