Genetic Counseling Unit for Familial Cancers

Hereditary cancers account for approximately 10% of all cancers. Cancer in more than one generation of a family, a cancer diagnosis at an earlier age than in the general population, the presence of more than one cancer in an individual, and cancer occurring on both sides of the body are indicative of hereditary cancer syndromes. Determining hereditary cancer risk, providing genetic counseling to individuals at risk, and implementing risk-reducing interventions based on the data obtained from genetic testing are important in reducing the risk of cancer and cancer-related death. In addition, the information obtained from these tests may reveal situations requiring multidisciplinary follow-up, making it possible to provide the right referral at the right time. A number of genes that predispose to various cancers (that is, when present in a person, they increase the risk of developing cancer compared with other people in the population) and the changes in these genes have been identified. The purpose of genetic tests is to determine whether there is any change in genes known to predispose to cancer. Many cancers, especially breast and colon cancer, have a varying likelihood of being familial. Diagnosing familial cancer syndromes affects the subsequent treatment, follow-up and screening plan of the individual with cancer, and also aims to have other members of the individual's family evaluated in this respect and placed in an appropriate screening and follow-up program, to take preventive measures, and to increase the chance of treatment by diagnosing a possible cancer early.

The Genetic Counseling and Risk Assessment Unit in Cancer operates within the Department of Preventive Oncology of the Hacettepe University Cancer Institute. Applications can be made by physician referral or individually. A file is opened for applicants at the first assessment. After the necessary information is provided, written pre-test consent is obtained. A “Cancer Risk Assessment Form” is filled in to determine personal, familial or lifestyle characteristics that may create cancer risk, as well as knowledge, attitudes and behavior regarding screening programs. A 3-generation family tree is then drawn. After the initial assessment, appropriate genetic tests for a possible hereditary cancer syndrome are requested in accordance with the criteria of the American College of Medical Genetics and Genomics (ACMG) and the National Comprehensive Cancer Network (NCCN). Informative genetic counseling is provided to individuals whose test results are positive.