Between 5-10% of common solid tumours (for example breast, ovary or colorectal) are inherited.

1. 1 in 3 people in the general population will develop cancer and therefore most cases will be sporadic.
   Recognising family patterns is not difficult, look for:
2. A high frequency of the same cancer within the family and/or
3. Early age of onset of cancer.
4. Multiple primaries in a single individual (such as bilateral breast cancer or two or more colorectal primaries).
5. Recognised familial cancer associations such as:
   - breast and ovary
   - breast and sarcoma
   - colorectal, uterus, ovary, stomach
   If several of these features are absent, then it is likely that the cancer isn't inherited.
6. The known breast cancer and colorectal cancer susceptibility genes account for very few sporadic cancers and only a percentage of inherited cancers (probably less than 50%).
7. Predictive genetic testing is only possible after the identification of a specific gene mutation in an affected family member, i.e. it is almost never possible unless there is a living affected family member or DNA banked from an affected person.
8. Always consider referral if there are 3 close family members with the same cancer type; otherwise refer to the referral guidelines.
9. Using the referral guidelines will avoid:
   - Expensive and inappropriate referral
   - Failure to identify families who may benefit from additional surveillance or advice
   - Failure to standardise the service across the region

For further advice and information contact WMFACS on 0121 607 4757 or Lucy Burgess on 0121 627 2630