August 2, 2015

Vanderbilt experts answer questions about hereditary cancer, testing for your risk, and concerns about insurance



Nearly 10 percent of all cancers develop because of a known gene change, or mutation, passed down within a family. People who inherit a cancer-related gene change have a higher risk of developing certain cancers.

Dr. Georgia Wiesner, director of the Clinical and Translational Hereditary Cancer Program with the Vanderbilt-Ingram Cancer Center, and Sarah Rutherford, a genetic counselor with the program, answer questions about hereditary cancer.


Q: What does “hereditary cancer” mean and how common is it?

Rutherford: Most cancers are “sporadic,” or in other words, nonhereditary. In hereditary cancers, you are born with a gene change or defect that increases your risk for cancer and it’s passed down from parent to child. Hereditary cancers account for 5 to 10 percent of all cancers.


Q: How do you determine who needs to be tested in a family?

Dr. Wiesner: We do a risk assessment that includes a look at family history and medical records to try to determine the type of cancer family syndrome. Once we have an idea of the gene, or genes, then we know what to test for.


Q: Are there other red flags for hereditary cancers?

Rutherford: Red flags for hereditary cancer include having multiple relatives on the same side of the family with the same kind of cancer, or relatives with cancers that we know are linked in a syndrome. For instance, breast and ovarian cancers cluster together. Also, seeing cancer in multiple generations … you can see the pattern of how it passed down from parents to children. And of course, early age of diagnosis.


Q: Can my insurance company drop me if I go through testing?

Rutherford: There is a law called the Genetic Information Nondiscrimination Act, or GINA, that was passed in 2008. It prohibits health insurance companies and employers from using genetic information in discriminatory ways — for instance, to define eligibility for coverage, to set premiums or to make hiring or firing decisions.

You should be aware that GINA does not apply to health insurance through a small business or to other types of insurance like life or disability.


The Hereditary Cancer Clinic is a clinical arm of the Vanderbilt Clinical and Translational Hereditary Cancer Program. The clinic provides evaluation and counseling for patients with familial cancer risk. For more information, or to make an appointment for a risk consultation, visit the Hereditary Cancer Clinic website.