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Evidence-led cancer risk guide

Family History and Inherited Cancer Risk

Some family patterns can point to an inherited susceptibility to cancer, but family history does not determine what will happen to one person. A careful assessment can clarify whether specialist advice or testing may be useful.

Read official NHS genetic-risk guidance (external link, opens in a new tab)Read Our Guide
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Quick guide

Family History and Inherited Risk at a Glance

What family history means
Cancer patterns in relatives can sometimes suggest a higher inherited risk, but many families include cancer without an inherited syndrome.
What details help
Cancer type, age at diagnosis, related cancers, more than one cancer in one person and any known genetic result.
Which relatives count
Information from maternal and paternal relatives can both matter.
Who to ask
Start with your GP. They may assess the pattern or refer you to a specialist genetics service.
Genetic testing
Testing is not automatically useful for everyone and may be preceded by genetic counselling or specialist assessment.
Symptoms
Family-risk assessment and screening do not replace medical assessment of a new or concerning symptom.

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2. What Family History Can Tell Us

Most cancers are not caused solely by an inherited cancer syndrome. Cancer is common, especially at older ages, so more than one diagnosis in a family does not automatically mean there is a pathogenic genetic variant.

This guide describes assessment in England. Genetics and surveillance pathways differ across the UK and eligibility can change.

3. Patterns That May Be Relevant

A healthcare professional considers the whole pattern rather than one detail. Features that may be relevant include several relatives with the same or related cancers, cancer diagnosed at an unusually young age, one person having more than one primary cancer, cancer affecting both paired organs, or a known pathogenic variant in the family.

The significance depends on who was affected, their age and how relatives are connected. Do not use a checklist to calculate your own risk; speak to a GP or genetics professional.

4. Both Sides of a Family Matter

Inherited variants can be passed through any parent, so maternal and paternal family histories both matter. For example, a pattern of breast and ovarian cancer on a father’s side can still be relevant to BRCA assessment.

Include parents, children, siblings, grandparents, aunts, uncles and, where known, more distant relatives. Family structures and biological relationships can be complex; share only what you know and are comfortable discussing.

5. Inherited Variants and Cancer Risk

BRCA1 and BRCA2 are examples of genes in which a pathogenic variant can increase the risk of certain breast, ovarian, prostate or pancreatic cancers. Lynch syndrome is caused by pathogenic variants in DNA-repair genes and can increase the risk of bowel, womb and some other cancers.

These examples do not form a complete catalogue. Having cancer in a family does not prove that a variant is present, and a variant can affect relatives differently.

6. Collecting Useful Family Information

If possible, record:

  • which relative had cancer and whether they are on the maternal or paternal side
  • the cancer type and where it started
  • age at diagnosis and, if relevant, age at death
  • whether one relative had more than one primary cancer or cancer in both paired organs
  • any pathology detail or known genetic-test result that the relative is willing to share

Family recollections may be incomplete or uncertain. Label what is uncertain and do not delay asking for advice because you cannot obtain every detail.

7. Assessment, Referral and Genetic Testing

Start with your GP if you are concerned. They can take a family history and check current referral criteria. A specialist genetics service may build a more detailed family tree, assess the pattern and discuss whether testing could answer a useful clinical question.

Testing often starts with a relative who has had cancer because this can make the result easier to interpret. NICE guidance recommends discussing the possible benefits, limitations, family implications and the possibility of an uncertain or uninformative result before testing.

8. What Results May Mean

A Pathogenic Variant Is Found

This may explain part of the family pattern and lead to discussion of surveillance, risk-reducing options or testing for adult relatives. It does not mean cancer is inevitable.

No Pathogenic Variant Is Found

This may be reassuring in some contexts, particularly when testing for a known family variant. In other contexts it may not explain the family pattern, and advice may still be based on family history.

A Variant of Uncertain Significance Is Found

This means there is not enough evidence to know whether the variant affects risk. It should not be treated as a confirmed disease-causing result. Genetics services can explain whether future reinterpretation is possible.

9. Screening and Risk Management

Some people at increased inherited risk may be offered surveillance or other risk-management options outside routine population screening. Recommendations depend on the gene, cancer type, age, sex, organs present, family history and personal preferences.

Explore the Library’s NHS Breast Screening, NHS Bowel Cancer Screening and PSA Test guides for general programme context. High-risk pathways are not interchangeable with routine invitations.

Whatever your family history or test result, contact your GP about a new or unusual change. The Cancer Symptoms guide explains why symptoms should not wait for screening or genetics review.

10. Common Myths

“Cancer on my father’s side does not count.”

Incorrect. Relevant variants can be inherited through either parent.

“A pathogenic variant means I will definitely get cancer.”

No. It can increase risk but does not predict an individual outcome.

“A negative test means my cancer risk is zero.”

No. Meaning depends on the test and family context, and everyone retains some cancer risk.

11. Frequently Asked Questions

Does cancer in my family mean I will get cancer?
No. Family history can influence risk but does not determine your future. Shared environment, chance and other factors may also contribute.
Which side of the family matters?
Both maternal and paternal relatives matter. Useful details include the cancer type, age at diagnosis, whether one person had more than one cancer, and any known genetic-test result.
Does everyone with a family history need genetic testing?
No. A GP or specialist can assess the pattern and decide whether genetics referral or testing is appropriate. Testing may be most informative when it starts with a relative who has had cancer.
What can a genetic-test result show?
It may identify a known pathogenic variant, find no such variant, or find a variant whose meaning is uncertain. A genetics professional can explain what the result does and does not mean.
Does a negative result mean my risk is zero?
No. The meaning depends on what was tested and whether a known family variant exists. Family history and other factors may still affect advice even when no variant is found.
What should I record before speaking to my GP?
If you can, note which relatives had cancer, the type, age at diagnosis, whether cancer affected paired organs or occurred more than once, and any genetic-test result. Do not delay asking for advice if details are incomplete.
Should I wait for genetic assessment if I have symptoms?
No. Contact your GP about symptoms or unusual changes now. Family-risk assessment and routine screening do not replace assessment of symptoms.

12. Evidence and References

These NHS and NICE sources support family-history collection, genetics referral, counselling and interpretation of results.

13. Official NHS Resources

14. How BloomShield Helps

Clear information is one part of equitable access. BloomShield’s connected programmes support understanding, practical access and navigation across screening and care pathways.

ScreenAccess™

identifies and helps address practical, social and service barriers to screening access.

ScreenConnect™

supports navigation, coordination and continuity across screening and care pathways.

Work with BloomShield to improve screening access