Cancer screenings can help find cancer at earlier, more treatable stages, so getting screened on schedule is important for your health. But what does “on schedule” mean, exactly? Recommendations for how often you should get tests such as mammograms, prostate cancer exams and skin cancer screenings often include a phrase like “For people at average risk.” We’re not all at average risk, though. If someone in your family is diagnosed with cancer, you may be at higher risk.
We talked to Madappa Kundranda, MD, a gastrointestinal medical oncologist, and Jennifer Siettmann, a genetic counselor, both at Banner MD Anderson Cancer Center at Banner Gateway Medical Center in Gilbert, AZ, to learn more about how having a family member with cancer impacts you and your recommended cancer screenings.
What types of cancers could be hereditary?
“Only 5 to 10% of all cancers diagnosed are considered hereditary (determined by genetic factors that can be passed on from parents to their children),” Siettmann said. However, some cancers may have a hereditary link that hasn’t been discovered yet.
Cancers that are more likely to be hereditary include:
Cancers that are not commonly hereditary include:
- Liver
- Bladder
- Bone
- Lung
- Testicular
- Esophageal
- Cervical
- Lymphoma
- Basal and squamous cell
How close does a relative have to be for my risk to increase?
It’s more concerning if you have first-degree relatives — parents, siblings or children — who have cancer. Cancer in second-degree relatives is still important, and you should tell your doctor about it. Second-degree relatives share 25% of your genes — aunts, uncles, grandparents, grandchildren, nieces, nephews and half-siblings. In those cases, it might not mean you need increased screening. “It usually depends on the type of cancer,” Dr. Kundranda said. Cancers can fall into three categories:
- Hereditary cancers (5-10%). A gene mutation is identified that can significantly increase your cancer risk. Your doctor may recommend aggressive management options.
- Familial cancers (20 to 30%). There’s a cluster of the same cancers in a family, but there’s no identified genetic predisposition. It could be a shared environment, similar lifestyles or an unknown genetic factor that’s behind the connection. In these cases, you could be at a moderately increased risk for cancer, and your doctor may recommend additional screening.
- Sporadic cancers (60 to 70%). Cancer probably occurred by chance or because of an environmental or lifestyle factor. This type of cancer in a family member doesn’t increase your risk.
Because your family history of cancer affects your risk, it’s crucial to ask your family members about any cancer diagnoses and to share that information with your doctor. According to the Centers for Disease Control and Prevention (CDC), you’ll want to ask:
- Who had cancer, and what type of cancer did they have?
- How old were they when they were diagnosed?
- If they are no longer living, how old were they when they died and what caused their death?
Your doctor will use this information to recommend a screening schedule for you.
How does a family member’s cancer diagnosis affect my screening recommendations?
“Having a family member with cancer can slightly increase your risk for that cancer,” Siettmann said. “The more times the same cancer appears in the family, the greater your risk for that cancer.”
If a type of cancer appears multiple times in your family, your doctor may recommend genetic testing to see if a gene mutation is causing cancer. People who may benefit from genetic screening usually fit into one of two groups:
- People who don’t have cancer but are at increased risk because they have two or more close family members with the same type of cancer, the same type of cancer in several generations of a family, Ashkenazi Jewish ancestry and a family history of breast or ovarian cancer, or multiple polyps in the stomach or intestines.
- People who have cancer and want to know if it’s genetic. In these cases, testing is usually recommended for people who developed cancer at an early age, have been diagnosed with two or more different cancers, developed a rare type of cancer, or have a family history of the same or a related type of cancer.
If genetic testing uncovers a gene mutation, your doctor can suggest a screening schedule based on your type of cancer. Even if you don’t have a gene mutation, you may need to be screened earlier or more often.
While some cancers have specific screening guidelines for people with family history, the screening recommendations for other cancers aren’t always as clear. “For cancers like ovarian, uterine, prostate, melanoma, kidney or stomach cancer, we recommend talking with a physician about the best screening schedule,” Siettmann said.
What symptoms should I watch for if I have a family history of cancer?
Everyone should be on the lookout for cancer symptoms, and it’s especially crucial for people with a family history of the disease. While many of these symptoms could be caused by something other than cancer, talk to your doctor if you notice:
- A lump or mass anywhere in your body that’s been there for a few weeks or is growing
- Unexplained weight loss
- Unexplained pain
- A change in your bowel or bladder habits
- Fatigue
- A sore that doesn’t heal
- A change in a mole or wart, or other unexplained skin changes
- Unusual bleeding or discharge
- Indigestion or trouble swallowing
- A nagging cough or hoarseness
The bottom line
If someone in your family has cancer, you could be at higher risk. Talk to your doctor about any cancer diagnoses in your family. “If you have a family history of cancer that you’re concerned about, sitting down with a genetic counselor is a great way to have a medical professional look at your family history and provide recommendations on screening and, possibly, genetic testing,” Siettmann said.
If you would like to connect with an expert who can help you evaluate your cancer risk, reach out to Banner Health.
