Patient cancer risk assessment for providers

Hereditary breast and ovarian cancer	Lynch Syndrome
The National Comprehensive Cancer Network has recommendations for patients who should be considered for genetic counseling.	Amsterdam and Bethesda criteria have been established by notable colorectal cancer groups to determine patients who should be seen for further genetic counseling.
A personal history of:	A personal history of:
• Ovarian cancer at any age • Male breast cancer • Breast cancer before age 45 • Triple negative breast cancer before age 60 • Bilateral breast cancer • Breast cancer at any age, with at least one relative with early-onset breast cancer (before age 50), invasive ovarian cancer, or at least 2 close blood relatives with breast and/or pancreatic cancer • Ashkenazi Jewish ancestry and a family history of breast or ovarian cancer	• A known high-risk cancer syndrome associated with colorectal cancer in the family • Colorectal or endometrial cancer with an abnormal immunohistochemistry (IHC) or microsatellite instability (MSI) • Endometrial cancer diagnosed younger than age 50
A family history of:	A family meeting Amsterdam Criteria, which follows the 3-2-1-0 rule:
• A known BRCA or other cancer mutation in the family • Bilateral breast cancer in a first or second-degree relative • Ovarian cancer in a first or second degree relative • Male breast cancer in a first or second-degree relative • A first or second degree relative (first degree including biological parents and siblings, second degree including grandparents, aunts, uncles, nephews, nieces or half-siblings), with breast cancer diagnosed before age 45 • Three or more HBOC-related cancer (breast, ovarian, pancreatic, prostate, sarcoma etc.), preferable with at least one early-onset HBOC related cancer diagnosis	• 3 or more relatives with colorectal or other Lynch-associated tumors • 2 successive generations are affected by Lynch-associated cancers • 1 or more of the cancer diagnoses occurred prior to age 50 • Other polyposis (abnormal tissue growth) or hereditary colorectal cancer diagnoses have been excluded

Please note: Patients who meet the above criteria should seek further genetic evaluation, however, a family member with a cancer diagnosis is typically the best candidate for testing