Family History Form

risky gene mutations may be found in anyONE, but are more likely in families with a history of certain types of cancer

Criteria may vary slightly, but for the most part, government-insured genetic counsellors will be looking for a confirmed genetic mutation anywhere in a family, or one or more of the following within the same side of a family:

Multiple individuals with breast, ovarian or prostate cancer

■ Breast cancer in both breasts

■ Breast and ovarian cancer in the same individual

■ Breast cancer at age 40 or younger

■ Breast cancer that is ‘triple negative’ at 50 or younger

■ Breast or ovarian cancer in a families with Ashkenazi Jewish heritage

■ Men with breast cancer

■ Men with early onset prostate cancer

■ Multiple individuals with uterine, stomach, colon, melanoma or pancreatic cancer

If your family has one or more of the red flags listed above, gather your family's cancer history  (you can print the form to the right for that purpose) and take it to your general practitioner to discuss the possibility of government-insured genetic testing. 

If your family history does not satisfy your health region's criteria for government-insured genetic testing or your doctor does not believe your history warrants genetic testing but you still want to know whether you carry a risky gene mutation, there are affordable, quick-turnaround pay-services available

Red Flags