Should my family get genetic testing if I have Colorectal Cancer

Should Your Family Get Genetic Testing?

This is an important question, and the answer is yes—your family members should consider genetic testing, especially if certain conditions apply to your situation. Let me explain why and what this means.

Why Family Testing Matters for Colorectal Cancer

According to NCCN Guidelines for Colorectal Cancer, genetic testing has become a critical part of care because:

• About 5-10% of colorectal cancers have a hereditary (inherited) component, meaning they run in families due to gene mutations passed down from parents to children
• If you carry a genetic mutation, your blood relatives (parents, siblings, children) have a 50% chance of inheriting the same mutation
• Family members who carry mutations may benefit from early screening and prevention strategies that could catch cancer at an earlier, more treatable stage

Which Family Members Should Be Tested?

According to NCCN Guidelines, genetic testing is recommended for your family members if:

1. You have been found to carry a pathogenic (disease-causing) mutation in genes like:

   • Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2, EPCAM)
   • BRCA1 or BRCA2
   • Other hereditary cancer genes

2. Your family has a strong cancer history, such as:

   • Multiple relatives with colorectal cancer
   • Colorectal cancer diagnosed before age 50
   • Family members with other related cancers (ovarian, endometrial, stomach cancer)

3. You have Ashkenazi Jewish ancestry (higher risk for certain mutations)

What Testing Involves for Family Members

• Simple blood test or saliva sample (non-invasive)
• Genetic counselor review to explain results and implications
• No cost or low cost if insurance covers it (especially if you've already been tested and found to have a mutation)

What Happens After Family Testing?

If family members test positive for a mutation, they can:

• Start enhanced screening earlier (colonoscopies at younger ages, more frequent monitoring)
• Make informed lifestyle choices to reduce cancer risk
• Pursue preventive options their doctor recommends
• Inform their own children about potential inherited risk

If family members test negative, they can be reassured they didn't inherit the mutation and don't need the same intensive screening.

Important Questions to Ask Your Doctor

1. Have I been tested for hereditary colorectal cancer syndromes? If not, should I be?
2. If I have a mutation, which of my family members should be tested first? (Usually starts with the closest relatives)
3. Can you refer my family to a genetic counselor to discuss testing options?
4. What screening should my family members do if they test positive?
5. Will insurance cover genetic testing for my family members based on my diagnosis?

The Bottom Line

Your family members benefit from knowing whether they carry the same genetic risk you do. This information is powerful—it allows them to take action before cancer develops, rather than waiting for symptoms. According to NCCN Guidelines, this cascade testing (testing relatives after an affected family member is identified) is now standard of care for colorectal cancer.

The most important first step: Make sure you have been tested for hereditary colorectal cancer syndromes. Once your results are known, your care team can guide which family members should be tested and what that means for their health.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.