Hereditary Cancer

Hereditary cancer is when a gene change that increases cancer risk is passed down from a parent to a child.
​​​​Being born with this kind of gene change means a person has a higher chance to get certain types of cancer, and those cancers may happen younger than expected.

Hereditary Cancer Program

The Hereditary Cancer Program provides genetic counselling and genetic testing for BC/Yukon residents who may have inherited an increased risk for certain types of cancer. Similar services are available across Canada and in other countries.

Use the tabs below to find information about hereditary cancer, genetic testing and genetic counselling.

 Visit the High Risk Clinic to learn more about follow-up care for eligible adults. 
Common Questions
This section provides answers to some common questions about hereditary cancer and the Hereditary Cancer Program. For more information, click "+" on the questions below.

 
Cancer starts when changes build up inside a cell. Those changes, called gene variants, can happen in a few ways:
  • Some are inherited from birth
  • Some happen by chance when cells divide
  • Some are caused by exposures in the environment
When these changes affect how a cell grows, it may lose its normal controls and turn into cancer. Gene changes happen more often as we age. Most cancers are more common at older ages.  ​

 
Hereditary cancer happens when a gene variant that increases cancer risk is passed down from a parent to a child. Being born with that gene variant does not mean cancer will develop. It does mean the chance of getting certain cancers is higher and may be at a younger age than usual. 

 

​Hereditary cancer is not common. Less than 10% of all cancer is caused by an inherited gene variant.

 

 
Cancer is very common. That means most people will have some relatives with cancer, especially in a big family. This does not mean the cancer in the family is hereditary. 
  • Age is the biggest risk factor for most cancers.
  • Shared lifestyle, environment and/or minor genetic changes may also play a role.​

 

​Sometimes a cancer has features that suggest it might be hereditary, even when there isn’t a strong family history of cancer. Examples include: 

  • Triple-negative breast cancer (negative results from testing the cancer for ER, PR and HER2 receptors)
  • High-grade serous ovarian cancer (including fallopian tube or peritoneal cancer)
  • Colon or uterine cancer with missing “mismatch repair” proteins (found through tumour testing)
​​​Some people who have colonoscopy are found to have more polyps than expected, or unusual polyps, which may also suggest an inherited cancer risk.

Families with hereditary cancer are more likely to have: 
  • Several people with the same type(s) of cancer 
  • Cancer in relatives over more than one generation (e.g. grandparents and parents)
  • Cancer that starts at earlier ages than is common for that type of cancer (e.g. breast cancer or colon cancer before age 50)
  • People with more than one cancer diagnosis
  • People with less common cancers 
Those signs must be in people who are closely related by blood, from the same side of the family, for it to suggest a cancer risk that might be passed down in the family.

 
Anyone with concerns about cancer in their family is encouraged to speak with a doctor or nurse practitioner (MD/NP). Bringing as much information as possible about relatives who have had cancer helps health care providers decide if a referral to the Hereditary Cancer Program is needed. For more details on personal and family history of cancer, review  the "Eligibility" section.

If a relative has a hereditary cancer gene variant, sharing that information with your healthcare provider can help guide next steps, including a referral to the Hereditary Cancer Program. For more information, review "Carrier Testing" in the "Eligibility" section.

 
Yes. Self-referrals are accepted when:
  • ​A relative has shared details about their hereditary cancer gene variant (e.g. letter, report, family reference number) or
  • There are concerns about cancer in the family and there is no family doctor or nurse practitioner available to refer.
Contact HCP:
  • Vancouver:  604-877-6000 local 672198
  • Send an email with any questions or a completed referral form
​

 
The Hereditary Cancer Program (HCP) provides and recommends the resources below for those who seek additional information and support related to hereditary cancer. The BC Cancer Library  is also an excellent resource for information on cancer-related topics.

Hereditary Breast/Ovarian Cancer 

Risk-reducing Mastectomy

Risk-reducing Ovary/Fallopian Tube Surgery

Polyposis

von Hippel Lindau Syndrome (VHL)

HCP Information for Health Professionals

 
Eligibility

Remember that cancer is common but hereditary cancer is not. This information may help you prepare to talk to your doctor or nurse practitioner (MD/NP) if you have concerns about cancer in your family. 

You may also wish to review some Common Questions (click tab above) or more detailed information about specific hereditary cancer syndromes.

 
Referral to the Hereditary Cancer Program may be appropriate if you have been diagnosed with any of the following:

  • a hereditary cancer gene variant through private pay genetic testing or a research study 
  • breast cancer at age 35 or younger
  • breast cancer described as “triple negative” (ER-, PR-, HER2-) and diagnosed at age 60 or younger
  • two separate breast cancers, with at least one diagnosed at age 50 or younger
  • ovarian cancer (including fallopian tube or peritoneal cancer)
  • breast, ovarian, pancreatic or prostate cancer and Ashkenazi Jewish heritage
  • colon cancer with missing “mismatch repair” proteins on tumour testing
  • endometrial/uterine cancer with missing “mismatch repair” proteins on tumour testing ​
  • unusual polyps or more polyps than expected found during colonoscopy​
  • pheochromocytoma or paraganglioma
  • pancreatic cancer or multiple melanomas 

 
Click the “Carrier testing” tab below if a relative has already had genetic testing. 

Families with hereditary cancer are more likely to have: 

  • several people with the same type(s) of cancer 
  • cancer in relatives over more than one generation (e.g. grandparents and parents)
  • cancer that starts at earlier ages than is common for that type of cancer (e.g. breast cancer or colon cancer before age 50)
  • people with more than one cancer diagnosis
  • people with rare or unusual cancers 
These must be in close relatives* on the same side of the family to suggest a cancer risk that might be passed down in the family.  

Referral is recommended if there are at least two of these feature in the family, OR if you have a close relative with any of the features listed in “Your Medical History” above. 

*Close relatives include: children, brothers, sisters, parents, aunts, uncles, grandchildren & grandparents on the same side of the family. History of cancer in cousins and more distant relatives from the same side of the family may also be important.

 
If a relative has had genetic testing and shared details (e.g. letter, report, family reference number), take that information to your MD/NP and ask to be referred to the Hereditary Cancer Program. ​

Contact HCP:

  • Vancouver:  604-877-6000 local 672198
  • Send an email 

 
Follow-up is available if you have already had a Hereditary Cancer Program genetic counselling appointment.

Reasons to request Hereditary Cancer Program follow-up include: 
  • new cancer diagnosis in yourself or a close relative 
  • new genetic test results in a family member
  • questions about: 
    • new options for genetic testing
    • cancer screening and risk-reduction
    • updated information related to a gene variant in your family
    • available support services
Please contact the Hereditary Cancer Program to provide new information or to request follow-up. 

Contact HCP:

  • Vancouver:  604-877-6000 local 672198
  • Send an email
What to Expect
Hereditary Cancer Program (HCP) referrals are usually made by a doctor or nurse practitioner (MD/NP). You can also start a referral for yourself by sending us an email. Review the Eligibility and Common Questions sections and talk to your MD/NP if you have concerns about cancer in your family.

HCP staff review every referral and the next steps may include:
  • Booking an appointment for you
  • Calling you to get more information
  • Sending you a letter that confirms you are on a waiting list 
  • Sending you a letter with information about web-based service options
If the chance of hereditary cancer is low you may receive an information letter instead of an appointment.  

 
Genetic counselling is provided by health professionals with specialized training in the areas of medical genetics, counselling, and hereditary cancer. The goals of genetic counselling are to help you: ​
  • Learn more about hereditary cancer
  • Understand the risks of developing cancer for you/your family
  • Make informed decisions about genetic testing
  • Discuss options for cancer screening and/or risk reduction. 
Genetic counselling  may include:
  • Information about genes and cancer
  • Review of your medical information and your family history
  • Cancer risk assessment - including screening options and risk-reduction strategies 
  • Information about genetic testing (for more information, see "What is genetic testing?" below)
  • Discussion about how this information may affect your family
You and your doctor/nurse practitioner will receive a written summary of your cancer risk assessment and screening recommendations.

 
Genetic testing looks for an inherited change (variant) in a gene that is known to increase the risk for certain types of cancer. It is usually done on a blood or saliva sample. 

Key points about genetic testing:
  • Only about 5-10% of all cancers are linked to an inherited gene variant.
  • Testing is offered if your personal and/or family history of cancer meets specific criteria.   
  • The first test in a family is usually offered to someone who has had cancer.
  • Storing of a blood sample may be a good idea for a person with uncertain health, if they might be the best person to start genetic testing in a family. 
  • Most genetic tests look at many hereditary cancer genes at once; we will review which genes are being tested and the possible results before testing
  • If a gene variant is found, testing becomes available for family members. 
  • Testing is usually offered to adults and is offered to children if the results will change their medical care. 
Genetic counselling can help with the decision to have genetic testing. 
 

 
In May 2017, the Genetic Non-Discrimination Act (GNA) was passed into Canadian law. Under GNA, it is illegal to require disclosure of genetic test results or uptake of genetic testing as a condition of a contract. That means that an insurer or an employer cannot require you to have a genetic test or to disclose the results of your genetic test. Additional protections were also added under the Canadian Human Rights Act and the Canada Federal Labour Code.

If you have additional questions please contact us by email. ​

 
Most appointments are done by telephone. You should plan to be in a quiet and private area.  Appointments may be 15-45 minutes. 
 

 
You are welcome to include another adult for support or invite relatives who share similar concerns about cancer risk in your family.

 
You may choose to watch a short educational video about hereditary cancer and genetic testing.  

 
The HCP team includes specialized physicians, genetic counsellors, nurses, genetic counselling assistants and other support staff. Working together, we provide hereditary cancer risk assessment, genetic counselling, genetic testing and follow-up. Our team also provides education about hereditary cancer topics. 

After Your Assessment