Personal history Family history
early onset of cancer diagnosis: breast cancer < 45 years, colorectal cancer < 50 years, etc. three close relatives (same side of family) 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 of family) 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 fist-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, MYH, Lynch syndrome mutations
colorectal or endometrial cancer with lack of expression by immunohistochemistry for mismatch repair protein many relatives with cancer but no criteria for testing
Table 2: Possible indications of referrals for hereditary cancer risk assessment.