RECOGNIZING HEREDITARY
CANCER

• Risk Assessment
• Hereditary Breast and/or Ovarian Cancer
• Hereditary Colon Cancer
• Amsterdam Criteria for Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
• Bethesda Criteria for HNPCC

Risk Assessment

1. Two or more relatives in a family have been diagnosed with cancer.
2. Cancer has been diagnosed in a family member under the age of 50 years.
3. The same type of cancer has occurred in several members of a family.
4. More than one type of cancer has occurred in one member of a family.
5. A rare cancer has occurred in one or more members of a family.

Hereditary Breast and/or Ovarian Cancer

1. A woman diagnosed with premenopausal breast and/or ovarian cancer (especially bilateral or multifocal disease).
2. A woman with breast or ovarian cancer diagnosed before age 50 years, who has a first- or second-degree relative with breast or ovarian cancer diagnosed before age 50 years.
3. A woman diagnosed with breast cancer at any age, who has two or more family members diagnosed with breast cancer and/or one or more family members diagnosed with ovarian cancer.
4. An unaffected individual who has a first- or second-degree relative with a known BRCA1 or BRCA2 mutation.
5. An Ashkenazi Jewish woman with breast cancer diagnosed before age 40 years or ovarian cancer diagnosed at any age.
6. An unaffected woman with two or more first- or second-degree relatives diagnosed with breast or ovarian cancer before age 50 years.
7. Breast and ovarian cancer in the same woman.
8. A man diagnosed with breast cancer, or an individual who has a male relative with breast cancer.

Hereditary Colon Cancer

1. Patient with diagnosis of Familial Adenomatous Polyposis (FAP).
2. Patient with diagnosis of Hereditary Nonpolyposis Colorectal Cancer (HNPCC), who meets the Amsterdam or Bethesda criteria (below).
3. Patient with diagnosis of colorectal cancer who is 55 years old or younger.
4. Patient with diagnosis of four or more adenomatous polyps.
5. Patient with diagnosis of Juvenile Polyposis, Peutz Jeghers syndrome, or other hereditary colorectal cancer syndrome.

Amsterdam Criteria for HNPCC

1. Histologically confirmed colorectal cancer in at least three relatives, one of whom is a first degree relative of the other two.
2. Occurrence of disease in at least two successive generations.
3. Age at diagnosis below 50 years in at least one colorectal cancer case.
4. Exclusion of Familial Adenomatous Polyposis (FAP).

Bethesda Criteria for HNPCC

1. Individuals with a colorectal cancer family history that meets the Amsterdam Criteria.
2. Individuals with colorectal cancer 45 years old or younger, or endometrial cancer  45 years old or younger, or a colorectal adenoma 40 years old or younger.
3. Individuals with colorectal cancer and a first-degree relative with colorectal cancer or an HNPCC-related cancer; one of the cancers diagnosed 45 years old or younger. (HNPCC-related cancers include colorectal, signet-ring-cell-type colorectal, endometrial, stomach, biliary tract, urinary tract, ovarian, and skin cancers.)
4. Individuals with two HNPCC related cancers, including synchronous and metachronous colorectal cancer.