I was recently diagnosed with cancer. Should my children or other family members pursue genetic testing to assess their risk?

Joan Steyermark, certified genetic counselor at the Mayo Clinic in Rochester, Minnesota

JOAN STEYERMARK: When you receive a cancer diagnosis, it’s normal to wonder what this might mean for the cancer risk of your children and other family members. The answer will depend on a variety of factors, including what type of cancer you have, your family history and your own genetic test results. Genetics plays a role in only 5% to 10% of cancers, meaning most diagnoses won’t be explained by an inherited genetic mutation you can test for.

The first step in assessing whether your children should undergo genetic testing is to determine if you carry a genetic mutation. Start by asking the doctor who diagnosed you if they recommend you undergo genetic testing and why or why not. If yes, ask them to refer you to a genetic counselor, who can evaluate your family history and look for patterns. For these discussions, it’s important to know your family history. Find out exactly what type of cancer your aunt had. Was it endometrial or ovarian cancer? Colon cancer or only polyps?

Genetic testing may be beneficial if, for example, you have colon cancer and multiple other relatives have had the same diagnosis. Anytime cancer is diagnosed before age 50, that’s also a red flag. Genetic testing is helpful if you already know a mutation, such as BRCA1 or BRCA2, runs in your family. It’s also recommended if a relative had ovarian cancer at any age or if you had cancer develop independently in two different organs, such as breast and ovary or breast and pancreas.

If a genetic counselor determines testing might be beneficial, it should always be presented to you as an option. It’s still up to you whether to have testing done and how you’ll share that information with others. You’ll want to think through how news of a genetic predisposition to cancer would affect your cancer journey and what it would mean for you and others emotionally.

If you decide to go forward with testing and it’s determined you indeed carry an inherited mutation, seek further information from your genetic counselor about what the results mean for your children and others in your family. If your test is negative, meaning you don’t carry a mutation that increases your own cancer risk, then no further testing for children or other relatives is needed. 

GENETIC TESTING // The National Cancer Institute answers questions on genetic testing, including whether at-home tests are an option. // The Cleveland Clinic explores the pros and cons of genetic testing for cancer risk.