Genetic Counseling and Testing
The Cancer Genetics Program provides expert care for patients with a recent cancer diagnosis or a personal history of cancer, as well as for individuals who have a family history of cancer. Genetic testing can help identify hereditary causes of cancer. Results can be used to inform treatment decisions and options for early detection and cancer prevention for those at a heightened risk of cancer.
Who Should Consider Genetic Counseling for Cancer?
Approximately 10-15% of all cancers are caused by genetic risk factors. Families with inherited cancer syndromes often have several family members, across multiple generations, who have had cancer.
Genetic counseling is especially important for anyone who has a personal or family history of any of the following:
- Any cancers, including breast, colon and uterine cancers, diagnosed before the age of 50
- Ovarian cancer diagnosed at any age
- Pancreatic cancer diagnosed at any age
- Metastatic prostate cancer
- Rare tumors (sarcomas, renal cancers)
- Two or more cancers diagnosed in the same individual
- Multiple colorectal polyps
- Male breast cancer
- Family member found to carry a mutation in a cancer susceptibility gene
- Pediatric cancers with a rare or unusual presentation or relapse of a cancer
- Family history of cancers across multiple generations
How should I prepare for my appointment?
In advance of your appointment, it is very helpful to collect and provide the following information:
- Your own cancer history, specifically any diagnoses of cancer you may have had
- Cancer diagnoses in your relatives including cancer type and their ages at diagnosis
- Has any relative had cancer genetic testing? If so, please provide a copy of the test report when possible
You will be asked to complete medical history and family history forms in advance of your appointment.
What can I expect at my appointment?
A visit usually includes an hour-long meeting in person or via telemedicine with a board-certified genetic counselor. In most instances patients also meet with a physician during this appointment. All of our genetic counselors and physicians have expertise in inherited cancer syndromes.
The evaluation includes:
- A detailed review of the family medical history
- Review of personal medical history and risk factors
- Cancer risk assessment and education about genetic syndromes
- Genetic testing, when indicated, and interpretation of the results
- Recommendations for cancer screening and prevention options, if necessary
- Referrals to resources for follow-up care and support
What is genetic testing?
For patients that are offered genetic testing, a small blood or saliva sample is collected. This sample can often be collected at the time of the genetic counseling visit. The sample is then sent to a laboratory for analysis. Depending on the test ordered, results are generally available in 4 weeks. The genetic counselor receives the results from the laboratory, and results are shared with each patient by telephone and/or in person. All patients also receive result letters and a hard copy of their result for their records.
We provide genetic counseling and genetic testing for a wide range of syndromes that can cause cancer, including:
- Hereditary Breast and Ovarian Cancer
- Hereditary gynecological cancers
- Familial adenomatous polyposis
- Lynch syndrome
- Multiple Endocrine Neoplasia 1
- Hereditary Diffuse Gastric Cancer
- Hereditary Pancreatic Cancer
- Von Hippel-Lindau syndrome (Center of Excellence)
- Known familial gene mutations
- Hereditary Cancer Syndromes
Will health insurance cover genetic testing?
Most insurance companies cover genetic testing costs given that patients meet criteria based on personal or family history of cancer. Your genetic counselor can help determine coverage and potential out-of-pocket costs at the time of your appointment. When not covered by insurance, the out-of-pocket cost of many genetic tests for cancer susceptibility is about $250.
High-Risk Cancer Prevention Programs
For individuals at high risk for certain cancers or identified as carriers of genetic syndromes that cause cancer, we work with specialized cancer prevention programs. In these programs we offer a continuum of care for early detection and prevention of cancers.
- Gastrointestinal Cancer Prevention and Genetics Program
- Hereditary Breast and Ovarian Cancer Program
- Muzzi Mirza Pancreatic Cancer Prevention & Genetics Program
Education and Training
As an academic institution we are proud to partner with and train students at all levels of education, including medical students, residents, fellows and students in the Columbia University Genetic Counseling Graduate Program.
- Wendy Chung, MD, PhD
- Kennedy Family Professor of Pediatrics and Medicine
- Director, Clinical Genetics Program
- Michelle Ernst, MS, CGC
- Katherine Foudy, MS, CGC
- Kimberly Hilfrank, MS, MPH, CGC
- Carrie Koval, MS, CGC
- Elana Levinson, MS, MPH, CGC
- Leyla Tabanfar, MS, CGC
- Joanna Urli, MS, CGC
Genetic Counseling Assistant
- Hannah Reich