VERIFIED CONTENTAuthor: lek. Patryk Jasielski

A family history of cancer diagnosis is always a big shock. There may be questions as to whether the person's relatives are also at risk of developing cancer. Cancer in a close family member, especially parents and siblings, increases the risk of developing cancer in other relatives as well. Tests that allow for its early detection and effective treatment are recommended then. Find out what tests are recommended if you have a family history of cancer.

Incidence statistics agree that the occurrence of cancer in a family member is a risk factor for cancer in other relatives. This is due to the carrier of genetic mutations, predisposing to cancer. Some of them are grouped into genetic syndromes, where the lifetime risk of developing cancer is different. In some, it may be as high as 100%. An example is familial adenomatous polyposis, where the diagnosis of this genetic syndrome is associated with a 100% risk of developing colorectal cancer. Some mutations are not classified as genetic syndromes, but predispose to cancer. This article describes tests that are primarily intended to help detect cancer early when it is still easy to treat. They should be performed at a certain age in everyone, even without a family history of cancer. However, in people with burden, they are indicated at a younger age and with a greater frequency than in people without such predispositions.

Genetic research

Consultation with a geneticist at the clinic is recommended for selected patients. Such a visit allows you to obtain professional advice and perform specialized genetic tests to detect mutations or genetic syndromes that increase the risk of cancer.

The genetic clinic also provides comprehensive care (including periodic prophylactic examinations) for patients with diagnosed mutations that increase the risk of cancer. A visit to this type of place is recommended when the family history of malignant neoplasms at a young age, e.g. colorectal cancer before the age of 50.

Other indications are the presence of bilateral cancer, e.g. cancer of both breasts, more than one cancer in a lifetimeor detection in the family of atypical, e.g. ovarian cancer, sarcoma.

Also, the presence of the same cancer in several members of a close family should make them visit such a clinic. Anyone who has had a family history of cancer can take advantage of genetic counseling in this type of place.

Colonoscopy

Colonoscopy is an endoscopic examination to assess the appearance of the large intestine. It also allows you to take samples and perform minor procedures, such as removal of polyps and their subsequent assessment in terms of their nature (whether they are benign or already malignant). This examination is indicated and reimbursed under the national program of combating cancer in all people over 50 every 10 years, up to the age of 65.

However, in people who have a 1st degree relative (i.e. a parent, sibling or children) diagnosed with colorectal cancer, the examination is recommended every 10 years from the age of 40. In people diagnosed with familial syndromes predisposing to this cancer, tests are recommended even earlier.

In familial polyposis, the first colonoscopy should be performed at 12-14. year of life and repeat every year. In Lynch's syndrome, relatives of people with Lynch syndrome must do a colonoscopy from the age of 25 every 1-2 years.

Faecal occult blood test

The faecal occult blood test is a screening test for gastrointestinal bleeding. It is indicated as an initial screening test for colorectal cancer. It is recommended for all people over 50 every 1-2 years. If blood is detected, then a colonoscopy should be performed, which is a much more detailed examination.

Gastroscopy

This is another endoscopic examination to assess the esophagus, stomach and duodenum. It is recommended in people with a family history of esophageal or gastric cancer. Also in the case of disturbing symptoms such as difficulty swallowing, heartburn in people over 40 and long-term gastro-oesophageal reflux disease.

Gastroscopy should be performed on relatives of patients with Lynch syndrome from the age of 25 every 1-3 years.

Mammography, ultrasound and MRI of the breast

Mammography is an X-ray examination of the breasts. It is recommended and reimbursed for all women between 50 and 69 every 2 years. Screening is sufficient for women with no increased risk of breast cancer.

However, in those with a burdened family history and diagnosed with genetic mutations (mainly in the BRCA1 and BRCA2 genes), screening is indicatedbefore.

From the age of 25, they should undergo MRI of the breast every 6-12 months until the age of 30. Later, it is advisable to perform MRI, alternating with mammography. Additionally, an ultrasound of the breast should be performed every 12 months.

Cytology and transvaginal ultrasound

Cytology is a test of a cell swab taken from the cervix. It is recommended and reimbursed for its performance from the age of 25 to 59 every 3 years for all women. Its more frequent performance is recommended in women who have had cases of cervical cancer in their immediate family.

Transvaginal ultrasound is recommended for women aged 30-35. every year if they have had a family history of Lynch syndrome. Also, in the case of detection of mutations predisposing to breast cancer (BRCA1 and BRCA2 genes), it is recommended to perform a transvaginal ultrasound from the age of 35 every 6 months.

Ultrasound of the thyroid gland and blood calcitonin levels

Thyroid ultrasound is recommended for relatives of people with diagnosed thyroid cancer (regardless of the type of thyroid cancer).

If medullary thyroid cancer is diagnosed, relatives should be checked, as it may be a genetic syndrome that predisposes to this type of cancer. In addition, the level of calcitonin, a hormone secreted by the thyroid gland, should also be measured. It is a marker of this type of cancer.

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Research