Inherited cancer genes and increased cancer risk
Some people have an inherited gene change (mutation) that can increase the risk of developing certain types of cancer.
Tests are available on the NHS that look for specific inherited gene changes.
You need to consider important issues before deciding to have a genetic test.
A gene change or mutation is a permanent change in the that makes up a . This can be inherited from a parent.
Changes to your genes can also happen during your lifetime. For example too much ultraviolet (UV) radiation from the sun can damage DNA in your skin cells and cause skin cancer. This is an environmental factor.
Doctors may use other terms for gene changes such as gene:
alterations
variants
faults
You may be able to have an NHS genetic test if:
you have a strong family history of cancer in your family and there is suspicion of an inherited gene change OR
an inherited gene change has been found in one of your relatives (predictive genetic testing)
By looking at your family history a specialist doctor can work out if you or a family member needs genetic testing.
This is testing for members of a family due to a known gene change. A close family member has a gene change that that can increase their risk of developing cancer (cancer predisposition).
You have predictive genetic testing to know if you have inherited this gene change too.
If you have the gene change it means you have an increased risk of developing cancer. But it doesn't mean that you have cancer or will definitely develop it
You need to be referred for genetic testing by a specialist doctor (a genetic specialist or counsellor).
You can pay for genetic testing. But you need to think about this carefully. You can find out more about private genetic testing at the bottom of this page.
Find out about inherited genes and specific cancer types.
Before you see a genetic specialist, your GP needs to work out if you have a strong family history of cancer.
Your GP will ask you some questions about your family history, including:
who in the family has had cancer and on what side of the family they are on
the type of cancer they had
how old they were when they were diagnosed
A strong family history means multiple close family members on the same side of the family who have the same cancer or related cancer types. If you have a strong family history of cancer, your GP can refer you to a genetic clinic.
Read our detailed information about what a family history of cancer means.
At the genetic clinic, you see a genetic specialist or counsellor. They will:
look in detail at your family history
work out your risk of developing cancer
work out whether you need a genetic test
Your first appointment might be face to face or over the phone. During this meeting, the counsellor will ask you questions about any members of your family who have had cancer. And how old they were when diagnosed.
You might need to talk to your relatives to find out who has had cancer. This can be an emotional time for you and other family members. In some families, relatives don’t want to discuss it, or may not feel emotionally ready. Your genetic counsellor can help you think about all these issues and find ways of coping with them.
Your genetic clinic appointment is your chance to ask questions. If you’re not sure what to ask you can look at our questions for your doctor.
You could print them out and add any other questions that you might have.
After looking at your family history, the genetic counsellor might tell you that it’s unlikely that you have an inherited gene change.
In certain situations the genetic counsellor might suggest you have regular screening because of your family history. This is more likely if members of your family have breast or bowel cancer.
You can find out about this in our information about:
There are also things you can do to reduce your risk of cancer. These include:
stop smoking
keeping a healthy weight
eating a healthy balanced diet
being more active
protect your skin and enjoy the sun safely
Find out about the causes of cancer and reducing your risk.
Your genetic counsellor will offer you a gene test if:
you have a strong family history of cancer
they think this might be caused by an inherited gene change
Your counsellor will discuss the advantages and disadvantages of genetic testing with you.
There are things you can do to reduce your risk of developing cancer if you are found to have a gene fault. For example, you might be able to:
make certain lifestyle changes
have regular screening to detect cancer early
take medicines to lower the risk of developing the cancer
have risk reducing surgery
Some genetic test results pick up a change in a gene. But it may not be clear whether it increases your cancer risk or not. This can be difficult to cope with.
You may have a constant worry about developing cancer if the test finds a gene change. You may also need to tell other relatives that they may have inherited the same gene change which can be difficult.
The Association of British Insurers (ABI) and the Government have agreed that people do not need to let insurance companies know the results of genetic predictive tests for cancer.
Insurance companies can still ask about family history. So if you have had a genetic test and it’s negative (there is no gene change), you may choose to tell the insurance company.
If you have had any problems with an insurance company that you can't sort out, you can make a complaint to the Financial Ombudsman Service.
Before you have a test, the genetic counsellor will talk to you about what your options are if you do have a gene change. This is usually part of the process of deciding whether to have the test or not. The options will depend on:
the particular gene change that you may have
which cancers you are at increased risk of developing
your age and plans for the future
If a gene change is found, you may have:
regular screening to pick up cancers early
treatment to reduce the risk of cancer, such as medicines or surgery
Read about possible screening and treatment options on the page about getting your genetic test results.
Making a decision about whether to have genetic testing can be difficult. It is normal to feel anxious. Thinking about the possibility of getting cancer is difficult. It may also bring back emotions you felt when other family members were diagnosed with cancer and what they went through.
It is important to take time to think it through. Before you decide, it can help to think about these questions.
How do you feel about having a test?
What will the result really mean for you and your family?
What will you do if the result is positive (if you have a gene change)?
How will you feel if the result is positive?
Will you feel reassured by a negative test?
Would you rather not know if you have an increased risk of cancer?
Is there treatment to reduce your risk?
If there is treatment, would you consider having it?
What will happen if you decide not to have the test – could you have regular screening?
Is regular screening available for the cancers that I’m at increased risk from?
Deciding whether to have a test is your decision to make. But talking with your family and knowing how they feel may help you to make the choice.
If your test shows that you have an inherited gene change, some members of your family may also be at risk of having that gene. They may also need to have testing. It is helpful to think through how you would feel about this and what it would mean for them.
It is worth thinking about who you might need to tell once you know the result. Talking to your genetic counsellor can help you to work this out.
After looking at the advantages and disadvantages of testing, some people choose not to have a genetic test. They may feel that they don’t want to know if they have a higher than normal cancer risk.
Some people decide they don’t want any preventative treatment even if they have a gene change. So they may not feel they have anything to gain by having the test.
Only you can decide what is best for you.
Children under the age of 18 cannot usually be tested. This is because anyone having a genetic test needs to be old enough to make their own choice about whether to have the test or not. They also need to be able to understand the possible benefits and risks that having the test might have on them and their family members.
The exceptions to this are tests for genes that can cause cancer at a young age and for which there is screening that works well. These include:
hereditary Leiomyomatosis and renal cell cancer (HLRCC)
Juvenile polyposis syndrome (JPS)
You won't be eligible for NHS testing if you don’t have a strong family history of cancer or if an inherited gene change hasn’t been identified in any of your relatives. You can still have a test if you are willing to pay for it privately.
Find out which genes can be tested for.
Before you agree to have private genetic testing, it might be helpful to consider the following things:
it's less likely that you have a gene change if you don't have any family history of cancer
the tests can’t guarantee to predict whether you will develop cancer
the cost of a genetic test
tests only look for certain genes
Make sure that testing is performed in an accredited genomics laboratory. And that genetic counselling is available as part of the service. It's important to get as much information as possible about your situation. And have the opportunity to discuss the advantages and disadvantages of testing.
If you have private health insurance, it’s worth checking that genetic testing is included in this.
It’s difficult to give a balanced view of prices because they can vary. This depends on what tests you have and the company you choose to use.
When contacting a private company, you could ask some of these questions.
Which genes can you test for?
How is the test done?
Does the cost include genetic counselling?
How will I receive the results?
What will the results mean for me and my family?
You can contact some private companies directly. Some companies ask for a referral from a GP or specialist doctor.
Having a Jewish ancestry means that you are at a higher risk of carrying a BRCA1 or BRCA2 gene change. Having one of these gene changes can increase your risk of developing cancer such as breast or prostate cancer in the future.
NHS England now offer testing to look at the BRCA genes in people of Jewish ancestry. To be able to have this testing you must live in England and:
have at least one Jewish grandparent
be 18 years of age or over
Go to more information about this NHS programme
You can read about:
Last reviewed: 03 Jan 2025
Next review due: 03 Jan 2028
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