Who Can Benefit From a Cancer Genetic Evaluation? Considerations for Genetic Risk Evaluation and Testing Based on Tumor Type and Pathology

Cancer genetic counseling and testing have become integral to medicine given expanding knowledge of genetic risk and recognition that a substantial fraction of cancer is hereditary. Access to genetic testing and precision medicine breakthroughs have led to new standards of care for diagnosis and treatment. Many tumor types, both common (eg, breast cancer) and rare (eg, pheochromocytoma), are associated with hereditary cancer syndromes. Even common tumors typically explained by exposures might have important genetic underpinnings (eg, lung cancer in nonsmokers, skin cancer in dark-complexioned individuals). Cancer genetics referral determination is nuanced, requiring consideration of specific tumor characteristics and other factors (eg, age at diagnosis, personal and/or family history). This publication is intended as a resource for oncology providers to make such determinations.