What Genetic Testing Can Tell You About Your Cancer Risk

Cancer touches many families. Understanding your personal risk related to family history can help you take a more active role in protecting your health.

Genetic counseling and testing give patients a way to look deeper at how family history, genetics and personal factors come together. Rather than predicting the future, this process helps people make informed decisions about cancer screening, prevention and long‑term care with their providers.

How Genetic Testing Works

Genetic testing does not look for cancer itself. Genetic testing for cancer risk looks for inherited gene mutations that may increase the likelihood of developing certain cancers.

“Genetic testing is looking at the DNA a person was born with. It’s reading through the DNA code looking for typos, or mutations, that are passed through the generations,” shares Kelly Morse, LCGC, a genetic counselor with ProMedica Cancer Institute. “If a person is born with one of those genetic mutations, then they’re going to have a higher risk for specific kinds of cancer compared to the general population.”

Some cancers, such as breast, ovarian, colon or pancreatic cancers are linked to certain gene mutations. However, most cancers are sporadic and not caused by inherited mutations.

“For most cancers, only about 5-10% are hereditary or due to inherited mutations,” Kelly explains. However, for those 5-10%, genetic testing can make a difference in outcomes. 

What Genetic Testing Cannot Tell You

Genetic testing is often misunderstood as a way to diagnose cancer.

“The testing that we do cannot tell you if you have cancer in your body right now,” Kelly says. “Instead, it helps you understand how high or low your risk is so that you and your providers can make informed choices regarding your screening.”

A negative genetic test result also has limitations.

“A negative genetic test does not mean a person will never have a cancer diagnosis,” Kelly says. “Instead, it means, based upon current technology, we do not see any genetic mutations that are known to make them more likely to develop specific kinds of cancer throughout their lifetime.”

What Higher‑Than‑Average Cancer Risk Means

Being told you have a higher‑than‑average risk for cancer can feel alarming, but it does not mean cancer is inevitable.

According to Kelly, there are three main ways someone may be considered higher-risk:

• Having an inherited gene mutation that increases risk for specific cancers
• Having a strong family history of certain cancers, even when genetic testing is normal
• Personal risk factors, such as smoking or abnormal biopsy findings

“Not every person who is high-risk will have a genetic mutation,” Kelly notes.

Because risk can come from many sources, reviewing personal and family history together is a critical part of understanding next steps.

Who should consider genetic counseling and testing?

There is no single checklist that determines who should pursue genetic counseling or genetic testing. Risk can be influenced by number of relatives with cancer, types of cancer, ages at diagnosis and personal health factors.

However, the Cancer Family History Questionnaire can help patients better understand whether they may be a candidate. This questionnaire helps identify possible inherited cancer risk and supports conversations about genetic counseling and testing.

Patients can complete the questionnaire and share it with their primary care provider. If any answers raise concern, a provider may recommend a referral to genetic counseling. The genetic counselor can assist with further risk assessment and discuss possible testing options.

If you’re unsure whether genetic testing makes sense for you, a genetic counseling consultation is often the best first step.

“Come to the initial consult so that we can educate you on what the testing is and isn’t,” says Kelly. “There is no requirement to proceed with the genetic testing just because you came to the consult. We want you to make an informed decision that is best for you and address any misconceptions.”

Understanding the Cost of Genetic Testing

Cost is another common concern for people considering genetic testing, but it is often more accessible than expected.

“Genetic testing is often more affordable than people think,” Kelly says. “If people meet criteria, insurance coverage has improved. Additionally, self‑pay options for cancer genetic testing can be around $250.”

During a genetic counseling visit, patients can review insurance coverage, testing options and potential out‑of‑pocket costs before deciding whether to move forward.

How Genetic Testing Can Change Screening and Prevention

For patients found to have inherited cancer risk, genetic testing can affect care decisions in meaningful ways.

“It can change how early someone starts routine screening compared to the general population,” Kelly says. “It can add screenings that the general population doesn’t typically qualify for.”

Depending on results, genetic testing may lead to:

• Earlier screening, such as starting mammograms or colonoscopies at a younger age
• Additional screening, like breast MRI or upper endoscopy
• Conversations about risk‑reducing surgeries for certain cancers

For individuals with inherited risk, these screenings often become preventive rather than symptom‑based, allowing providers to monitor health more closely over time.

Understanding the Emotional Side of Genetic Testing

Genetic testing is not just a medical decision. It can also bring emotional considerations, especially for people who have never had cancer themselves.

“Sometimes people just don’t want to know,” Kelly says. “The knowledge that they’re at a higher likelihood for something to happen can negatively interfere with some people’s everyday life.”

For others, having clearer information brings relief and direction.

“Other people feel that they would much rather have this information so that they, their providers and their family can take all steps to either prevent or catch a cancer at an earlier stage when it is most treatable,” Kelly says.

For many patients, genetic test results become a tool for empowerment. Understanding risk allows people to take ownership of their future health, make thoughtful decisions about screening and prevention, and plan proactively for longevity.

Take Action Early for Long‑Term Health

If you believe you may have a higher‑than‑average cancer risk, start by talking with your doctor about your personal and family history. Together, you can decide whether genetic counseling may be helpful and if so, they can provide a referral.

For patients deemed high risk, ProMedica Cancer Instittue's High Risk Clinic works closely with genetic counselors to develop personalized plans for screening, imaging and follow‑up care. Individuals are seen one to two times to year by the High Risk Clinic to ensure they’re being followed by the most current screening guidelines.

“Early detection saves lives. I know we hear that often, but it is true,” Kelly says. “The earlier we can make a plan for screening and/or risk reduction, the higher chance we have to catch a cancer early, when it’s most treatable, or to prevent it from happening altogether.”

Genetic testing is not about certainty. Genetic testing allows patients to plan ahead, personalize screening and make informed decisions about long‑term health.

Kelly Morse, LCGC
Kelly Morse is a genetic counselor with ProMedica Cancer Institute. View her profile.