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Hereditary Cancer and Genetic Testing

Guidelines for genetic testing in people diagnosed with  cancer

Up to 10% of men with cancer have an inherited mutation that caused their cancer. There are national guidelines that outline which men with cancer should have genetic counseling and testing for an inherited mutation. Men with cancer, should speak with a genetics expert about genetic testing if they have any of the following:

  • a tumor test result suggests an inherited mutation (for example, a , or mutation in the tumor that may indicate an inherited mutation in one of those genes). 
  • a blood relative who tested positive for an inherited mutation in a gene linked to cancer.
  • metastic cancer diagnosed at any age.
  • intraductal/cribriform cells found on pathology.
  • cancer that is categorized as very-high- or high-risk based on pathology.
  • also diagnosed with male breast cancer.
  • Eastern European (Ashkenazi) Jewish ancestry. 
  • one or more first-, second-, or third-degree relatives diagnosed with breast cancer at age 50 or younger, or ovarian, pancreatic, male breast cancer,  prostate cancer or intraductal/cribriform  cancer at any age.
  • two or more close relatives diagnosed with breast or cancer at any age.

Men with the following are unlikely to have an inherited mutation:

  • diagnosed with localized cancer with a gleason score of <7 and:
    • no prior history of breast or pancreatic cancer
    • no first-,second-, or third-degree relative who was diagnosed with breast, ovarian, pancreatic or cancer.  


Other people who may benefit from genetic counseling and testing

You may benefit from additional genetic counseling and expanded genetic testing if you had genetic testing in the past, you tested negative, and the following applies to you:

  • your situation matches any of the above, and
    • you had a test that only looked for one or a few genes, or 
    • you had genetic testing before 2014. Genetic testing has improved, and laboratories can now find gene mutations that may have previously been missed.

cancer survivors and those in treatment should speak with a genetics expert to see if testing is right for them. 


Guidelines for genetic testing for relatives of people who have been diagnosed with  cancer

Genetic counseling and testing is also recommended for anyone with a first-degree or second-degree relative who has been diagnosed with or high-grade  cancer. 

See our sections Testing Guidelines by Cancer Type and Genetic Testing for People Who Have Never Been Diagnosed with Cancer for additional guideline information. 

finding-experts finding-experts

Health care providers who are specially trained in genetics can help you more clearly understand your risk for . The following resources can help you locate a genetics expert in your area.

  • The National Society of Genetic Counselor website offers a searchable directory for finding a genetic counselor by state and specialty. To find a genetic counselor who specializes in cancer genetics, choose "cancer" under the options "Area of Practice/Specialization." 
  • InformedDNA is a network of board-certified genetic counselors providing this service by telephone. They can also help you find a qualified expert in your area for face-to-face genetic counseling if that is your preference. 
  • JScreen is a national program based out of Emory University that provides low-cost at-home genetic counseling and testing with financial assistance available.
  • Grey Genetics provides access to genetic counselors who offer genetic counseling by telephone. 
  • The Genetic Support Foundation offers genetic counseling with board-certified genetic counselors. 
  • FORCE's toll-free helpline at: 866-288-RISK, ext. 704 will connect you with a volunteer board-certified genetic counselor who can answer general questions about genetic testing and cancer and help you find a genetics expert near you. 
  • FORCE Peer Navigator Program will match you with a volunteer who has undergone genetic counseling and can help you navigate resources to find a genetic counselor near you.
  • Ask your doctor for a referral to a genetics expert. 

updated: 03/16/2022

find-support find-support

The following organizations offer peer support services for people with, or at high risk for cancer:

updated: 01/30/2022

paying-for-service paying-for-service

Insurance coverage for genetic counseling and testing

Most health plans cover genetic counseling and testing for inherited gene mutations linked to cancer in people who meet the national guidelines. The cost of testing and your out-of-pocket charges may vary based on several factors.

People who are denied coverage for genetic testing can file an appeal (FORCE has sample appeal letters). Your healthcare provider can work with your insurance company and help you file an appeal if needed. Low cost testing may be available for $250 or less. Learn more about coverage for genetic counseling and testing here

testing under the Affordable Care Act

Under the Affordable Care Act (ACA), insurance companies must pay for both genetic counseling and  testing with no out-of-pocket costs for women who meet certain criteria. The ACA regulations are limited to testing for and only and do not cover genetic counseling or testing in all situations. You can learn more about testing under the ACA here

Medicare and Medicaid coverage of genetic testing

Genetic counseling and testing is typically covered by Medicare for people already diagnosed with cancer who are in treatment or for whom test results may affect their care. Most state Medicaid programs cover genetic testing for and mutations for people who meet requirements, which vary by state. You can read more about Medicare and Medicaid coverage of genetic testing here.

Financial assistance or low cost genetic testing

JScreen is a national program based out of Emory University that provides low-cost at-home genetic counseling and testing with financial assistance available. Many laboratories offer low-cost genetic testing or financial assistance programs. Programs vary, so if you are not eligible for assistance through one lab, consider contacting other labs to see if you qualify .   

updated: 02/15/2022

Last updated February 02, 2022