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Cancer Genetics Referrals

This information is aimed at professionals considering referring a patient to the genetics service to discuss their personal or family history of cancer.


To return to the main Genetics homepage, please click here.

 

To make a cancer genetic referral, please write to:

Consultant Clinical Geneticist
North West Thames Regional Genetics Service
Level 8V
Northwick Park and St Mark’s Hospitals
Watford Road

Harrow HA1 3UJ

Tel: 020 8869 2795

Fax: 020 8869 3106

Urgent referrals can be faxed to 020 8869 3106 and should be clearly marked as urgent.

Expedited testing of BRCA1 and BRCA2 is available for patients where a positive BRCA result would alter management. To refer for urgent BRCA testing, please complete the Urgent BRCA1/BRCA2 Test Genetic Referral Form and fax it to 020 8869 3106.

If you are a GP, please ask the patient to complete a Cancer family history questionnaire and send this with the referral letter. A cancer questionnaire needs to be accompanied by a referral letter.

If you are a referrer who is not a GP, please feel free to pass on a questionnaire to your patient for him or her to complete and return to us.  Please indicate this in your referral letter. 

Please contact us if you would like a printed copy of the questionnaire.

 

Once a cancer questionnaire is received the information is reviewed by a member of the cancer genetic team. For certain cancers, such as breast cancer, a face to face consultation will only be offered if the individual fulfils criteria for genetic testing. If the family history does not fulfil these criteria then a letter will be written to the patient and referrer with our risk assessment and choices for cancer risk management. The letter will also state if other family members could be offered genetic testing.

Cancer Referral Guidelines

Below shows suggested criteria for referral but if you wish to seek advice about a referral, please call the Kennedy-Galton Centre on 0208 869 2795 and ask for a member of the cancer genetics team.

The affected relatives MUST be blood relations, but can be through the maternal or the paternal side.

Known cancer susceptibility gene

  • If a cancer susceptibility gene has been identified in the family

Breast cancer

Families with: 
  • four or more breast cancers*
  • both breast and ovarian cancer. This includes a single individual who develops both cancers.
  • three breast cancers* diagnosed at average age of 60 or less 
  • male breast cancer and at least one additional breast or ovarian cancer
  • Ashkenazi Jewish ancestry and at least 1 breast or ovarian cancer
  • a recognised BRCA1 or BRCA2 mutation in family
Female diagnosed with breast cancer who:
  • was diagnosed <age 30
  • has triple negative breast cancer diagnosed <50 years (Please include pathology report with referral)
  • was diagnosed <50 years and has an affected relative* diagnosed <50 years
  • was also diagnosed with ovarian cancer.
  • meets the family history described above (counting her own breast cancer as one of the cases)
* Someone with bilateral breast cancer counts as two affected individuals.

 

Gynaecological cancer

  • Individual diagnosed with non-mucinous ovarian cancer
  • Individual diagnosed with endometrial cancer under the age of 50
  • Any family with two or more cases of ovarian cancer
  • Any family with ovarian cancer AND colorectal cancer, endometrial cancer or breast cancer under the age of 50

Colon cancer

  • Families with colorectal cancer AND either endometrial and/or ovarian cancer
  • Families with two cases of colorectal cancer diagnosed under the age of 70
  • Families with colorectal cancer diagnosed under the age of 50
  • Anyone with a diagnosis of or family history of a high-risk susceptibility condition such as familial adenomatous polyposis (FAP, also known as polyposis coli) or Lynch syndrome (also known as hereditary non-polyposis colorectal cancer (HNPCC))
  • Individuals with 10 or more adenomas

Prostate cancer

  • Any family with two cases of prostate cancer where one is diagnosed under the age of 65.
  • Families with three or more cases of prostate cancer at any age

Li-Fraumeni families/Li-Fraumeni-like

  • Individuals with adrenocortical cancer diagnosed at any age
  • Individuals with choroid plexus cancer diagnosed at any age
  • Individuals with rhabdomyosarcoma diagnosed below 5 years of age
  • Families with three relatives with the following tumours under the age of 60 years or two tumours in one patient with an affected relative: breast cancer - sarcoma - melanoma - adrenocortical carcinoma - primary brain tumour - leukaemia - prostate cancer - germ cell tumour
  • Two sarcomas in first or second degree relatives diagnosed at any age

Other families

  • Any family with an unusual pattern of cancer in the family, such as, more than one close relative diagnosed with a rare cancer at an unusually young age for that type of cancer