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Table 2 Possible indications of referrals for hereditary cancer risk assessment

From: Hereditary cancer risk assessment: essential tools for a better approach

Personal history Family history
Early onset of cancer diagnosis (e.g. breast cancer < 45 years, colorectal cancer < 50 years) Three close relatives (same side) with cancer of the same or syndromically related type (breast/ovary, colorectal/endometrium)
Multiple associated primary cancers: breast/ovary, colorectal/endometrium Two close relatives (same side) with cancer of the same or related type with at least one affected under 50 years
Male breast cancer One first-degree relative with early onset cancer (breast < 45 years, colorectal < 50 years)
Ovarian, fallopian tube, primary peritoneal cancer One first-degree relative with multiple primary cancers
Breast cancer and thyroid, sarcoma, adrenocortical carcinoma Two or more relatives with uncommon cancers (sarcoma, glioma, hemangioblastoma, etc.)
Multiple colon polyps (>10 cumulative) Relatives of patients with known BRCA, APC, MUTYH, mismatch repair mutations
Colorectal or endometrial cancer with microsattelite instability and/or lack of expression of mismatch repair protein(s) by immunohistochemistry Many relatives with cancer but no criteria for testing are fulfilled