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Risk Factors for Inherited Breast and/or Ovarian Cancer:

1. Multiple cases of breast cancer (particularly where diagnosis occurred at less than 50 years) and/or ovarian* cancer (any age) in the family - especially in closely related relatives in more than one generation.

2. Age at diagnosis of breast cancer less than 35 years.

3. A family member diagnosed with both breast and ovarian* cancer.

4. Breast and/or ovarian* cancer in Jewish families.

5. Family member(s) with primary cancer occurring in both breasts, especially if one or both cancers were diagnosed before age 50.

6. A family member diagnosed with invasive serous ovarian* cancer.

7. Presence of male breast cancer in the family.

8. Family member with an identified BRCA1 or BRCA2 mutation.

9. Presence of other associated cancers or conditions suggestive of an inherited cancer syndrome.

*includes cancer of the Fallopian tubes and primary peritoneal cancer

Risk Factors for Inherited Colorectal Cancer:

1. Multiple cases in the family of cancers related to the Hereditary Non-Polyposis Colorectal Cancer (HNPCC) spectrum with at least one relative affected with colorectal or endometrial cancer. An age of onset less than 50 years, in closely related relatives and in more than one generation would raise the index of suspicion.
   
    Note:  Cancers related to the HNPCC spectrum include: colorectal, gastric, small bowel, hepatobiliary, pancreatic, endometrial, 
                ovarian, kidney, ureter, sebaceous carcinoma of the skin and brain cancers.

2. Age at diagnosis of colorectal cancer less than 35 years.

3. Multiple primary cancers in one family member (see 1. above for tumour sites).

4. Family member with Familial Adenomatous Polyposis (FAP), or 10 or more histologically confirmed adenomatous polyps (suggestive of attenuated FAP).

5. Family member with a colonic adenoma or cancer with high microsatellite instability (MSI).

6. Family member with a known mutation causing either HNPCC or FAP.

Genetic Testing:

Genes for the hereditary forms of breast and ovarian cancer, and colorectal cancer have been identified in the past several years. Testing for these genes is now possible in certain clinical situations.

Genetic testing is offered only to families that meet criteria for genetic testing, and in most cases will be offered to a family member affected with cancer first. If a mutation is detected, testing will then be available to unaffected members. If affected family members are unavailable for testing, only in exceptional circumstances will genetic testing be offered to an unaffected individual. The specific criteria for eligibility for genetic testing are available from your local genetics center or familial cancer clinic, or the Nov. 2001 issue of the Ontario Medical Review (available on-line at www.oma.org).