Cancer Council Victoria advocates and supports general practitioners to accurately assess patients’ personal and family histories of cancer to identify if they need referral to a Familial Cancer Centre.
Patients who present with a family history can be anxious about what it means to them and may require a different pathway to what they have prepared for. As we know, patients who express concerns that cancer 'runs in their family', may not mean they have a genetic susceptibility to cancer or an altered gene.
In collaboration with Victorian Familial Cancer Centres, this information aims to provide general practitioners relevant advice on how to risk assess, support, and refer patients onto Familial Cancer Centres. It also contains links to resources to build knowledge and training modules to further develop applicable skills.
What you’ll find on this page:
Risk assessing patients with a family history of cancer
If a patient presents with a family history of cancer, that does not mean they should automatically be referred to a Familial Cancer Centre.
It's important to assess a patient’s level of risk of an inherited altered gene that increases their susceptibility to cancer.
To determine a patient’s level of risk, you will need to compile a basic family tree and history of cancer.
You will require the following key information from the patient:
- Which family members have had cancer?
- What is their relationship with the patient?
- What was the type of cancer?
- What was the age of the family member when they were diagnosed?
You should not require any additional personal details to determine the patient’s risk level.
Once a patient’s brief family history has been compiled, please refer to the eviQ GP referral guidelines for cancer genetics assessment to complete a risk assessment.
Here are additional resources to assist with assessing risk:
- iPrevent tool: an Australian tool designed for self-administration by women and collaborative use with clinicians and is the only tool that links the breast cancer risk assessment directly to the relevant risk management guidelines.
- CanRisk Web tool: this online clinical tool can be used to calculate the future risks of developing breast or ovarian cancer using information on family history, lifestyle/hormonal risk factors, rare pathogenic variants in moderate and high-risk breast/ovarian cancer susceptibility genes, common breast/ovarian cancer genetic susceptibility variants (Polygenic Risk Scores) and mammographic density. It can also be used to calculate the likelihood of carrying mutations in the moderate to high-risk genes BRCA1, BRCA2, PALB2, ATM, CHEK2, BARD1, RAD51C and RAD51D.
Based on the patient’s level of risk, there are different follow up steps to take, for example:
||Follow up support
||Refer to a Familial Cancer Centre. See below for a list of centres in Victoria.
||Continue to monitor risk regularly and manage according to clinical guidelines.
|Moderate (Patient has been genetically tested and no altered gene was identified)
||Access this clinician resource to help explain what they can do in the future.
Next steps if your patient has an inherited altered cancer gene
If your patient has accessed Familial Cancer Centre services and is identified as having an inherited altered gene, you can access clinician resources to help guide treatment and ongoing risk management and care.
Here are additional resources you can access to support patients with a genetic cancer susceptibility:
- eviQ Cancer Genetics Patient support resources: fact sheets for specific types of genetic cancers providing general information about: the increased risk of cancer for those with an inherited altered gene; how this risk may be managed; and what this may mean for family members.
- NSW Centre for Genetics Education: resources for patients to assist in understanding different aspects of cancer genetic testing, risk management, as well as guidance for talking to their family about genetic information.
Find a Victorian Familial Cancer Centre
Please note, due to COVID-19, the majority of Familial Cancer Centre consultation appointments are conducted via telehealth.
Austin Health Clinical Genetics Service
Catchment: Northern and Eastern Melbourne; Ballarat; Shepparton; Albury/Wodonga
Catchment: Austin Health Genetics Service provides services from:
- Northern Hospital, Epping
- Eastern Health, Maroondah Hospital, Ringwood East
- Ballarat Base Hospital
- Goulburn Valley Health, Shepparton Health
Level 8, Harold Stokes Building, 145 Studley Road, Heidelberg VIC 3084
Ph: (03) 9496 3027
Fax: (03) 9496 4385
Parkville Familial Cancer Centre
- The Parkville Familial Cancer Centre provides services from:
- Peter Mac’s Parkville VCCC site
- Peter Mac at Box Hill
- Peter Mac at Bendigo
- The Royal Melbourne Hospital (City Campus)
- The Western Hospital (Footscray)
- Andrew Love Centre (Geelong Hospital)
- Warrnambool Community Health Centre (Warrnambool Base Hospital)
Parkville Familial Cancer Centre is a joint service incorporating Peter MacCallum and Royal Melbourne Familial Cancer Centres.
Peter MacCallum Cancer Centre
Familial Cancer Centre
Level 1, Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne VIC 3000
Ph: (03) 8559 5322
Fax: (03) 8559 7371
The Royal Melbourne Hospital
Department of Genomic Medicine and Familial Cancer
Level 2 Centre, 300 Grattan Street, Parkville VIC 3050
Ph: (03) 9342 7151
Fax: (03) 9342 4267
Monash Health Familial Cancer Centre
Catchment: South East Melbourne, Mornington Peninsula; Gippsland
Catchment: Monash Health Familial Cancer Centre provides services from:
- Alfred Hospital, Prahran
- Peninsula Health, Frankston Hospital
- LaTrobe Regional Hospital, Moe
- Monash Health, Moorabbin Hospital
- Monash Health, Clayton Hospital
Monash Medical Centre
246 Clayton Road, Clayton VIC 3168
Ph: (03) 9594 2009
Fax: (03) 9594 6046
Familial cancer online training modules
Referrals to Familial Cancer Centres for BRCA1 and BRCA2 testing
Developed by Cancer Council Victoria. This online training aims to improve GP understanding about altered genes of BRCA1 and BRCA2, risk assessing patients and referral to Familial Cancer Centres. It takes about an hour to complete, is free and practical, and offers RACGP and ACRRM professional development credits.
Referrals to Familial Cancer Centres for Lynch syndrome risk assessment
Developed by Cancer Council Victoria. The online training aims to improve GP understanding about Lynch syndrome, risk assessing patients and referral to Familial Cancer Centres. It takes about an hour to complete, is free and practical, and offers RACGP and ACRRM professional development credits.
Other useful resources and tools
These additional clinical resources can help general practitioners provide the best support to a patient who may be susceptible of hereditary cancer.