Common hereditary cancers and implications for primary care

The identification of genes that place individuals at high risk of breast, ovarian, and colorectal cancer has greatly advanced our understanding of ca ncer predisposition over the past decade. This knowledge has received much attention from the media, and referrals to geneticists and surgeons, and re quests for genetic testing, have risen. We review the published evidence fo r the management of people at increased risk of hereditary cancers, to draw attention to areas of uncertainty and to discuss implications for primary care. We focus on common inherited cancers, since they will have the greate st effect on clinical practice over the next decade. Cancer genetics offers a model of how information on the genetics of other common diseases could affect primary care in the future. Strategies to support the integration of genetic medicine in primary care are needed to enable primary-care practit ioners to identify individuals at raised genetic risk and to reassure patie nts for whom genetic testing and increased surveillance offer little benefi t.