Asymptomatic patients should be referred to Clinical Genetics for assessment of family history and eligibility for screening and/or genetic testing.
Referrals are triaged by the Clinical Genetics team. Depending on the family history an assessment may be completed by letter or by sending the patient a family history questionnaire (if further information is required) or by appointment.
If appropriate, a referral for colonoscopy screening will be made by Clinical Genetics.
Please note that not all referrals will be allocated an appointment with Clinical Genetics.
Referrals are triaged by the Clinical Genetics team. Depending on the family history an assessment may be completed by letter or by sending the patient a family history questionnaire (if further information is required) or by appointment
Please note that not all referrals will be allocated an appointment with Clinical Genetics.
WHO TO REFER
When making a referral, please include as much information as possible about the:
- Type of cancer
- Relationship of any affected relatives to the patient being referred
- Name(s) of affected relative(s); especially those previously seen in the genetics clinic
- Age(s) at diagnosis of affected relative(s)
Patients who have a family history but no personal history of cancer
A woman is defined as being at increased risk of ovarian cancer if she has a first-degree relative affected by cancer within a family that meets one of the following criteria:
ovarian cancer family history
| Number of relatives affected with cancer | Family History |
| 1 relative | with both breast and ovarian cancer |
| 2 relatives | both with ovarian cancer, any age, who are first degree relatives of each other |
| One with ovarian cancer at any age, and one with breast cancer diagnosed under age 50 years, who are first degree relatives of each other | |
| 3 relatives | * One relative with ovarian cancer at any age, and two with breast cancer diagnosed under 60 years, connected by first degree relationships |
| three or more family members with colon cancer, or two with colon cancer and one with stomach, ovarian, endometrial, urinary tract or small bowel cancer in two generations. | |
| If there is a known cancer syndrome in the family e.g. mutation in one of the following genes:- BRCA1, BRCA2, MMR (MHL1, MSH2, MSH6, PMS2), RAD51C or RAD51D. | |
| All affected family members must be on the same side of the family. | |
| *Closest relative can be SDR if family history is on the father’s side of the family | |
*First degree relatives: parent, sibling, child
Second degree relatives: grandparent, aunt/uncle, grandchild, niece/nephew
Patients with one close relative with ovarian cancer have a low genetic risk (similar to population risk). They should NOT be referred to Genetic Services.
Ovarian cancer screening: There is no clear evidence that screening has an impact on mortality from ovarian cancer. Because of this screening is NOT offered, even in high risk women.
Risk reducing ovarian surgery: Women identified as being at increased genetic risk of ovarian cancer can be offered prophylactic salpingo-oophorectomy (consider around age 35 to 40 years).
Patients who have had cancer – for consideration of genetic testing
Patients who have had cancer AND who meet any of the following criteria may be eligible for genetic testing:-
- An individual diagnosed with non-mucinous ovarian cancer or fallopian tube or primary peritoneal cancer
- An individual diagnosed with both breast AND ovarian cancer
- Individual with a personal history of breast, ovarian or colon cancer PLUS a significant family history.
- Families of Ashkenazi Jewish/ Polish descent with a history of breast/ovarian cancer in the family
In most families, a genetic test for cancer predisposition will not be available to family members who have not developed a cancer unless a pathogenic gene mutation has already been identified in an affected relative. If a mutation has been identified in the family please include in your referral the name and date of birth of the affected relative, and if possible which genetic centre they attended.
How to Refer
Please send referrals electronically
SCI-Gateway
WGH.ClinicalGenetics@nhslothian.scot.nhs.uk
or by post to
Referral Administration
SE Scotland Clinical Genetics Service
Western General Hospital
Crewe Road South
Edinburgh
EH4 2XU
If you wish to discuss a referral please call 0131 537 1116 and ask for the Duty Staff, alternatively email WGH.ClinicalGenetics@nhslothian.scot.nhs.uk
National Guidelines
SIGN 135: Management of Epithelial Ovarian Cancer
Ovarian Cancer Guidelines SIGN 2013
Ovarian Cancer Guidelines Summary Sign 2013
Other support information
Target Ovarian Cancer
Risk factors / family history / symptom awareness
Ovarian Cancer Symptoms Leaflet
