When Should You Get Tested for Hereditary Cancers?

If you have a family history of cancer, you may be wondering whether genetic testing for hereditary cancers is right for you—and if so, when you should consider getting tested. Hereditary cancers are caused by inherited gene mutations passed from one generation to the next. While they only account for about 5% to 10% of all cancers, understanding your genetic risk can help you make informed decisions about your health and potentially detect cancer earlier when it’s most treatable.

This blog explores when you should consider genetic testing, who might benefit, and what types of cancers are most commonly associated with inherited risk.

What Are Hereditary Cancers?

Hereditary cancers occur when individuals inherit a genetic mutation that increases their risk of developing certain types of cancer. Some of the most well-known hereditary cancers include:

• Breast cancer (associated with BRCA1 and BRCA2 mutations)

• Ovarian cancer

• Colorectal cancer (linked to Lynch syndrome and familial adenomatous polyposis)

• Prostate cancer

• Pancreatic cancer

• Melanoma

These gene mutations can significantly increase your lifetime risk of developing cancer, which is why early testing and screening are important tools for prevention and early detection.

When Should You Consider Genetic Testing?

Genetic testing isn’t recommended for everyone. However, you may want to consider it if you meet any of the following criteria:

1. You have a personal or family history of cancer at a young age

   1. Breast cancer diagnosed before age 50

   2. Colorectal cancer diagnosed before age 50

   3. Endometrial (uterine) cancer diagnosed before age 50

2. You have multiple close relatives who have had the same or related types of cancer

3. There is a known genetic mutation in your family

4. You have Ashkenazi Jewish ancestry and a history of breast, ovarian, or pancreatic cancer

5. You or a family member has had a rare cancer such as male breast cancer or medullary thyroid cancer

6. You’ve had multiple cancers yourself (e.g., breast and ovarian cancer or colon and endometrial cancer)

If any of these apply to you, it’s important to discuss genetic counseling with your healthcare provider. A genetic counselor can help determine whether testing is appropriate and guide you through the decision-making process.

Timelines for Common Hereditary Cancer Screenings

Below are general recommendations for when to consider genetic testing or begin screening if you’re at high risk for specific hereditary cancers. These guidelines may vary based on your family history and should always be discussed with your healthcare team.

1. Hereditary Breast and Ovarian Cancer (BRCA1/BRCA2)

   1. Genetic testing: Often considered between ages 25–30 if there is a strong family history

   2. Breast cancer screening: Begin clinical breast exams at age 25; annual MRIs starting at 25–30; mammograms added by age 30

   3. Ovarian cancer screening: May include transvaginal ultrasound and CA-125 blood tests starting at age 30–35

2. Lynch Syndrome (Colorectal, Endometrial, and Other Cancers)

   1. Genetic testing: Consider by age 20–25 if there is a family history

   2. Colonoscopy: Begin every 1–2 years starting at age 20–25, or 2–5 years earlier than the youngest family diagnosis

   3. Endometrial and ovarian cancer screening: Discuss options with your provider; may include annual transvaginal ultrasounds and biopsies starting around age 30–35

3. Familial Adenomatous Polyposis (FAP)

   1. Genetic testing: As early as age 10–12 if there is a family history

   2. Colonoscopy or flexible sigmoidoscopy: Every 1–2 years starting at age 10–12

4. Hereditary Prostate Cancer

   1. Genetic testing: Consider in men with a strong family history, especially if multiple relatives were diagnosed before age 65

   2. PSA testing: May begin between ages 40–45 depending on family history and genetic risk

What Happens If You Test Positive for a Genetic Mutation?

Testing positive for a hereditary cancer mutation doesn’t mean you will definitely develop cancer—it simply means your risk is higher than average. Based on your results, your care team may recommend:

• Earlier and more frequent screening (such as mammograms or colonoscopies)

• Preventive surgeries (like mastectomy or oophorectomy)

• Risk-reducing medications

• Lifestyle changes and health monitoring

Deciding when to get tested for hereditary cancers is a personal decision that should be guided by your family history, age, and overall health. If you think you may be at risk, start the conversation with your primary care provider or a genetic counselor. With the right information, you can take proactive steps to manage your health and reduce your risk.

Written By: Carolyn Vandenbroek, MSDM

Reviewed By: Srilata Gundala, MD

Disclaimer: This blog provides general information and should not replace personalized guidance from your healthcare team. Always follow your unique care plan and speak with your medical provider before making decisions about genetic testing or cancer screening.