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Cancer Genetics Risk Assessment and Counseling (PDQ®): Genetics - Health Professional Information [NCI] - Cancer Risk Assessment and Counseling

Comprehensive cancer risk assessment is a consultative service that includes clinical assessment, genetic testing when appropriate, and risk management recommendations delivered in the context of one or more genetic counseling sessions.

Several professional organizations emphasize the importance of genetic counseling in the cancer risk assessment and genetic testing process. Examples of these organizations include the following:

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  • American College of Medical Genetics.
  • American Society of Clinical Oncology.[1,2,3]
  • American Society of Human Genetics.
  • International Society of Nurses in Genetics.
  • National Society of Genetic Counselors.[4,5,6]
  • National Comprehensive Cancer Network.[7,8]
  • Oncology Nursing Society.
  • Society of Gynecologic Oncologists.[9]

A list of organizations that have published clinical practices guidelines related to genetic counseling, risk assessment, genetic testing, and/or management for hereditary breast and ovarian cancers is available in the PDQ summary on Genetics of Breast and Ovarian Cancer.

Genetic counseling informs the consultand about potential cancer risks and the benefits and limitations of genetic testing and offers an opportunity to consider the potential medical, psychological, familial, and social implications of genetic information.[4,10,11] Descriptions of genetic counseling and the specialized practice of cancer risk assessment counseling are detailed below.

Genetic Counseling

Genetic counseling has been defined by the American Society of Human Genetics as "a communication process that deals with the human problems associated with the occurrence, or risk of occurrence, of a genetic disorder in a family." The process involves an attempt by one or more appropriately trained persons to help the individual or family do the following:

  1. Comprehend the medical facts, including the diagnosis, probable course of the disorder, and the available management.
  2. Appreciate the way that heredity contributes to the disorder, and to the risk of recurrence (occurrence), in specific relatives.
  3. Understand the alternatives for dealing with the risk of recurrence (occurrence).
  4. Choose a course of action that seems to them appropriate in view of their risk, their family goals, and their ethical and religious standards and act in accordance with that decision.
  5. Make the best possible adjustment to the disorder in an affected family member and/or to the risk of recurrence (occurrence) of that disorder.[12]
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