Individuals should be considered for genetic testing if they have:

• Breast cancer at any age³²
• Ashkenazi Jewish ancestry³³
• Uterine/endometrial cancer ≥50y^34*

Genetic testing is also recommended when there is a personal or family history^†‡ of:

• Breast cancer ≤50y^33†
• Ovarian cancer (including peritoneal and fallopian tube)^33†
• Multiple primary breast cancer diagnoses^33†
• Triple-negative breast cancer (ER-, PR-, HER2-)^33†
• Male breast cancer^33†
• Pancreatic cancer^33‡
• Metastatic or high-risk prostate cancer^33‡
• Uterine/endometrial or colorectal cancer <50y^34‡
• A known pathogenic/likely pathogenic variant (mutation) of a cancer susceptibility gene in a blood relative<sup>33,34
  
  *</sup>In individuals untested for MMR deficiency status in tumor or with absence of MMR deficiency in tumor^{34
  †}Eligible relatives include first-degree (parent, sibling, child) and second-degree (grandparent, grandchild, aunt, uncle, niece, nephew, half-sibling)
  ^‡Eligible relatives include first-degree (parent, sibling, child)
  
  Criteria listed are not comprehensive. See NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for complete testing criteria (NCCN.org).

Individuals should be considered for genetic testing if they have:

• Colorectal cancer ≥50y^34*
• 10-19 cumulative adenomas³⁴

Genetic testing is recommended when there is a personal history of:

• Any Lynch syndrome-related^† cancer <50y³⁴
• Two Lynch syndrome-related^† cancers in the same person³⁴
• Mismatch repair (MMR) deficiency and/or abnormal IHC in a tumor³⁴
• >20 cumulative adenomas³⁴
• Diffuse gastric cancer (DGC) at any age³⁴
• A known pathogenic/likely pathogenic variant (mutation) of a cancer susceptibility gene in a blood relative^33,34

Genetic testing is also recommended when there is a personal or family history^‡ of:

• Pancreatic cancer (exocrine)^33‡
• ≥3 close relatives^§ with Lynch syndrome-related† cancers³⁴
• Colorectal or uterine/endometrial cancer <50y^34‡
• Colorectal cancer or uterine/endometrial cancer and another Lynch syndrome-related^† cancer in the same person^34‡

Criteria listed are not comprehensive. See NCCN Guidelines® for complete testing criteria (NCCN.org).

Individuals should be considered for genetic testing if they have::

• Prostate cancer ≤55y³³
• Intermediate risk^* prostate cancer with intraductal/cribriform histology³³

Genetic testing is recommended when there is a personal or family history^* of:

• Metastatic, node-positive, high- or very high-risk^‡ prostate cancer³³
• Prostate cancer and a relative^§ with one of the following cancers:
  • Breast cancer ≤50y³³
  • Ovarian cancer³³
  • Pancreatic cancer³³
  • Male breast cancer³³
  • Metastatic, node-positive, high- or very high-risk^‡ prostate cancer³³
• Prostate cancer and Ashkenazi Jewish ancestry³³
• A known pathogenic/likely pathogenic variant (mutation) of a cancer susceptibility gene in a blood relative^33,34

Criteria listed are not comprehensive. See NCCN Guidelines® for complete testing criteria (NCCN.org).

Genetic testing is recommended when there is a history of:

• Kidney cancer ≤46y³⁶
• Bilateral or multifocal kidney tumors (including angiomyolipomas)³⁶
• Kidney cancer and close relative(s)* with kidney cancer³⁶
• Specific types of kidney tumors that can be associated with hereditary syndromes^36†
• Features^‡ associated with hereditary kidney cancer syndromes³⁶
• A known variant (mutation) in a close relative³⁶
• When test results could impact surgical decision-making or treatment considerations³⁶

Criteria listed are not comprehensive. See references for additional testing considerations.

Genetic risk evaluation is recommended when there is a history of:

• Acute myeloid leukemia (AML)/Myelodysplastic syndromes (MDS) <50y^37,38
• Aplastic anemia or bone marrow failure <50y³⁸
• Hematologic malignancy and other primary cancers in the same person or close relatives³⁸
• Multiple close relatives with hematologic malignancies³⁸
• Hematologic malignancy and other features suggestive of a hereditary bone marrow failure syndrome³⁸
• A known variant (mutation) in a blood relative (especially a donor candidate for allogeneic hematopoietic cell transplantation)³⁷
• If somatic testing identifies a variant that could have clinical implications if it were present from birth (germline)^37,38

Criteria listed are not comprehensive. See references for additional testing considerations.

Genetic testing is recommended when there is a history of:

• Paraganglioma³⁹
• Pheochromocytoma³⁹
• Gastrinoma⁴⁰
• Multiple pancreatic neuroendocrine tumors (NET)⁴⁰
• Recurrent primary hyperparathyroidism or multigland hyperplasia⁴⁰
• Parathyroid adenoma <30y⁴⁰
• Medullary thyroid cancer⁴¹
• Adrenocortical carcinoma⁴²
• Multiple tumors or features associated with a hereditary endocrine tumor syndrome (such as MEN1 or MEN2)^* in the same person^40,41
• A known variant (mutation) in a blood relative^39-41

Criteria listed are not comprehensive. See references for additional testing considerations.

Genetic testing should be considered in individuals with a personal history or family history of:

• >3 invasive cutaneous melanomas⁴³
• >3 cases of invasive melanoma and/or pancreatic cancer in close relatives^43*
• ≥2 BAP1-associated tumors^44†
• Certain BAP1-associated tumors^† at young ages⁴⁴
  • Uveal melanoma <40y⁴⁴
  • Cutaneous melanoma <18y⁴⁴
  • Malignant mesothelioma <50y⁴⁴
• Other combinations of cancers and tumors among individuals and close relatives^* including melanoma, breast, colon, ovarian, prostate, and clear cell kidney cancers, astrocytoma, mesothelioma, paraganglioma, and/or atypical Spitz tumors⁴⁵

Criteria listed are not comprehensive. See references for complete testing considerations.