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Internists should advise patients with elevated cancer risk on genetic counseling options

Internists can help identify patients who could benefit from genetic counseling due to a high risk for familial cancer, a history of cancer at a young age or a history of multiple cancer occurrences, according to a commentary published in Annals of Internal Medicine.

“With increasing capability and affordability of next-generation sequencing technology, commercial laboratories now offer an array of multigene panels that can analyze many cancer susceptibility genes in parallel,” Veda N. Giri, MD, director of the cancer risk assessment and clinical cancer genetics at Sidney Kimmel Cancer Center of Thomas Jefferson University, and colleagues wrote. “Genetic counseling for inherited cancer risk is evolving rapidly to keep pace with these discoveries and improved technology.”

In recent years, genetic testing in oncology has expanded rapidly. According to the commentary, genetic counseling, which involves the collection of the patient’s medical history, tumor pathologic and molecular features and prior genetic test results, helps patients understand the implications of test results. These counseling sessions help determine the probability of hereditary cancer syndromes and guide germline genetic testing.

Internists receive much of this information during consultation, including a patient’s cancer risk, meaning they can identify patients who may benefit from genetic counseling, according to the authors. Referral for genetic consultation and early detection of an inherited gene mutation gives a patient options for cancer prevention. Internists who identify a genetic mutation in their patients should discuss referring family members for genetic counseling, they wrote.

“Internists play a critical role in identifying patients who may be predisposed to cancer and could benefit from genetic consultation,” Giri and colleagues wrote. “Close collaboration between internists and cancer genetics programs is vital to provide genetic evaluation and tailored screening and management options for the benefit of patients and their families.” – by Savannah Demko

Disclosures: Giri reports no relevant financial disclosures. Please see the full study for a complete list of all other authors’ relevant financial disclosures.