Genetic Risk Assessment Program
Approximately 10 percent of cancer is due to an inherited predisposition. This means there is a change or mutation in a gene that can lead to an increased risk to develop certain types of cancer. An inherited predisposition can be passed from parents to children.
The Cancer Genetic Risk Assessment Program at the Dignity Health – Cancer Institute at St. Joseph’s Hospital and Medical Center provides genetic counseling, education, and when appropriate, facilitates genetic testing for those concerned about an inherited predisposition to cancer.
There are certain cancers that are more likely to be related to a familial predisposition. These can include breast, ovarian, colon, prostate, thyroid, brain, pancreatic cancers, melanoma and others.
“The benefit of identifying an inherited predisposition to cancer in a family is the information it can provide to the individual and their family. The process of genetic counseling allows people to become informed about their risk to develop cancer and then make informed decisions regarding screening,” explained Kimberly Brussow, MS, a certified genetic counselor for the Dignity Health – Cancer Institute at St. Joseph’s and certified by the American Board of Genetic Counseling.
When to Seek Genetic Counseling
People with a personal or family history of cancer may benefit most from genetic counseling. The cost of the genetic counseling may be covered by insurance. When calling the program to schedule an appointment, our coordinators will review the family history and insurance information and discuss anticipated coverage and cost of genetic counseling. Genetic testing is a separate cost and discussed in more detail during the genetic counseling appointment, after the personal and family history has been reviewed in depth.
You or your physician may make a referral to the Genetic Risk Assessment Program when there is a personal or family history of:
- cancer at an earlier age than expected for that type of cancer (for example, under age 50)
- an individual with more than one type of cancer or with bilateral cancer
- many close relatives with the same type of cancer, on the same side of the family
- rare cancers in the family (for example male breast cancer)
It is ideal, and most informative, to begin the process of genetic counseling and testing with the person in the family who has been diagnosed with cancer. For many reasons, this is not always possible.
An initial genetic counseling appointment lasts 60-90 minutes. At the appointment, she will:
- review your medical history
- collect detailed family history for both maternal and paternal sides of your family
- assess your individual risk to develop cancer based on the family history
- discuss if the family history is concerning for an inherited predisposition and review the risk to carry an inherited predisposition
- review the possible genetic test results
- discuss your options for surveillance, and risk reduction, review the risks, benefits and limitations of genetic testing
- explain current status of legislation regarding genetic discrimination
- arrange genetic testing if desired and indicated
- If genetic testing is pursued, results are typically available in 3-4 weeks. Once the results are received, the results will be interpreted within the context of your personal and family history. The genetic counselor will call to review the results by telephone, with additional appointments scheduled as needed. Medical management recommendations will be reviewed and implications for your family discussed.
- For more information about scheduling a genetic counseling appointment, call (866) 603-5804.
What’s covered by insurance and what’s not?
Genetic counseling may be covered by your insurance plan. For those that do not have coverage for genetic counseling, a discount is available if payment is received the day of the genetic counseling. Our intake coordinators can speak with you about coverage and review your out-of-pocket cost for the genetic counseling.
If genetic testing is indicated, this is a separate cost and performed at an independent laboratory. Criteria have been developed to identify who would benefit from genetic testing and many insurance companies have their own criteria in place to determine coverage for genetic testing. During the appointment with the genetic counselor, options for genetic testing and coverage of genetic testing will be reviewed in detail based on your personal and/or family history.
Concerns about Genetic Discrimination
There are federal laws in place the prevent health insurance companies and employers from discriminating based on genetic information. The Genetic Information Nondiscrimination Act of 2008 (GINA), states that it is against the law to request, require or use genetic information to make decisions about your eligibility for health insurance or your health insurance premium, contribution amounts, or terms of coverage. GINA also includes legislation related to employment.
Additionally, the results of genetic testing are considered ‘Protected Health Information (PHI)’ as described in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and release of these results is limited.