Genetic testing for cancer risk: Insight for health care providers

Between 5% and 10% of all cancers are hereditary, which means that changes in specific genes are passed from one generation to another. People who inherit one of these gene mutations will have a higher-than-average lifetime risk of developing cancer.

Because most cancer cases aren’t genetic, not every patient needs genetic counseling and testing is not for every patient.

“That’s why it’s important for health care providers to help patients determine if they have genetic factors that may increase their cancer risk,” says Banu Arun, M.D., professor in Breast Medical Oncology and Clinical Cancer Prevention and co-medical director of MD Anderson’s Clinical Cancer Genetics Program. “There are several quick risk assessment tools that health care providers can use to identify patients that might need genetic counseling and, if indicated, genetic testing.”

Here’s what health care providers should know about genetic counseling and testing when it comes to cancer.

Health care providers play a role in recognizing high-risk patients

Specific gene mutations have been linked to over 50 hereditary cancer syndromes, and researchers continue to discover more. Genetic counseling and testing has benefits regardless of whether a gene mutation is found. “We can help patients make informed decisions about their health care if we identify a cancer risk gene,” Arun says.

With the shortage of trained genetic providers, there is a growing need to include other health care providers in the process of patient identification and assessment. However, studies have shown that health care providers do not sufficiently recognize those who should be referred for genetic counseling and testing.

Unfortunately, a significant number of mutation carriers don’t receive genetic counseling and testing. “Presently, less than 50% of patients who meet genetic cancer testing guidelines are referred for genetic evaluation and testing,” says Arun.

Health care providers should assess and screen patients for genetic counseling

Health care providers should implement strategies to assess and screen their patients in daily practice. There are several checklists, questionnaires and online referral tools available in addition to the published professional guidelines that can detect patients that should be referred for genetic counseling.

Arun recommends that health care professionals encourage patients to seek genetic counseling if they have a personal or family history that seems to indicate an inherited cancer gene mutation.

A genetic counselor can help an individual or family understand available genetic tests, explain test results and provide information on the implications of knowing the test results.

“This is important because genetic testing results can have a big impact on the patient and the family, both medically and psychosocially,” Arun says. These include:

• Medical treatment: Several important medical decisions may be impacted by knowing a patient’s underlying risk of developing cancer. Identifying these patients through testing can potentially allow for early preventive measures as well as help guide appropriate screening and treatment options.
  
  
• Family: A patient’s positive genetic testing results mean other family members may also have the genetic mutation and are at increased risk for cancer. As a result, that patient’s family members should also receive genetic counseling.
  
  
• Psychological: Genetic testing to estimate cancer risk may prompt an emotional or psychological reaction. Discussion of risk is important and needs to take place with a trained genetic counselor.

“If doctors implement genetic testing processes in their routine clinical practice, it will increase patient and provider awareness of genetic cancer risk,” Arun says. “More patients will receive the recommended testing and we will improve patient care.”

Register for the 4^th Annual Hereditary Cancer Symposium for Health Care Providers, which will be held online on Friday, April 16 and Saturday, April 17.

Refer a patient to MD Anderson online or by calling 1-877-632-6789.