Individuals with any of the following in their personal or family history:

• A known genetic pathogenic variant/mutation identified in a cancer susceptibility gene

Any of the following diagnosed at any age:

• Ovarian cancer (including fallopian tube and primary peritoneal cancers)
• Male breast cancer
• Pancreatic cancer
• Metastatic prostate cancer
• Medullary thyroid cancer
• Pheochromocytoma/Paraganglioma
• Adrenocortical carcinoma

Any of the following diagnosed at a young age:

• Breast cancer
• Colorectal cancer
• Endometrial cancer
• Gastric cancer
• Other cancer(s) diagnosed at unusually young ages

Two or more cancers diagnosed in the same person
A personal and/or family history of > 3 cancers on the same side of the family
Cancers with specific tumor characteristics reported from pathology:

• Triple negative breast cancer
• Colon, uterine or other cancers showing evidence of mismatch repair (MMR) deficiency, either by microsatellite instability (MSI) or loss of MMR protein expression at any age

Individuals of Ashkenazi Jewish descent with a personal or family history of breast, ovarian, pancreatic, or high-grade prostate cancer
Non-cancerous personal or family history that may indicate referral include:

• > 10 cumulative adenomatous polyps
• > 2 hamartomatous polyps
• > 5 serrated polyps proximal to sigmoid colon
• Parathyroid, pituitary, or carcinoid tumors
• Dysmorphic features in addition to cancer history
• Mucocutaneous hyperpigmentation of the mouth, lips, nose, eyes, genitalia, or fingers

Full referral guidelines are at the bottom of this page. If you are concerned about a patient’s personal or family history of cancer, a genetics professional can help determine if further risk assessment and/or genetic testing is indicated.