Regional cancer genetics service primary care referral guidance

GGC - Referral Management
NHS GGC

The West of Scotland Cancer Genetics service is based at the Queen Elizabeth University hospital,
Glasgow. Please send all referrals to:

West of Scotland Cancer Genetics Service
Department of Clinical Genetics
Level 2A, Laboratory Medicine
Queen Elizabeth University Hospital
1345 Govan Road
Glasgow G51 4TF
Phone: 0141 354 9201 (reception)

We offer face to face appointments in the Queen Elizabeth University Hospital, Glasgow. Alternatively
remote video or telephone appointments can be offered. We are not able to provide peripheral clinics.
When making a referral, please include as much information as possible including:

• 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)
• Family History Questionnaire 

It is rare for cancer to be strongly inherited. In most families, a genetic test for cancer predisposition will
not be available unless a gene alteration has already been identified in an affected relative. If this has
been identified, please include in your referral the name and date of birth of the affected relative, and
which genetic centre was involved in identifying the gene so that we can access the relevant information
in order to offer a test to your patient. In other families, we usually need to test an affected relative first.

For breast cancer, the majority of families will not have an alteration in the known genes BRCA1 and
BRCA2, and testing will not be available to relatives.

Families eligible for testing include an individual with breast cancer under 40, 3 breast cancers under 50,
4 breast cancers under 60, or individuals with triple negative breast cancer under 60 or high grade
serous ovarian cancer at any age.

Storage of blood for DNA

For patients with cancer who would like to have blood stored for possible testing in the future:

• Please send 5mls of blood in an EDTA tube to the DNA lab, Level 2B Laboratory Medicine Building, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF

• Please write ‘cancer family for storage’ on the request form.

The service

The service includes those who are well but at moderate or high risk of cancer (see guidance).

• Individuals at low risk of cancer may still request a referral despite reassurance from their doctor or nurse. Please highlight this within the referral letter so that the genetics service is aware or the patient will not be given an appointment.

• Individuals who may be eligible but are too young for screening (or are over 50 and get routine breast screening) will be contacted by letter rather than being seen in clinic.

• If someone has a complex family history of several unusual cancers (not covered by this guidance) then please consider referral or write for advice.

• Many patients will be contacted by letter for further information. If patients are assessed as low or moderate risk they may be dealt with by letter.

Cancer risk: breast cancer

(*see notes regarding first degree relatives)

 

BREAST CANCER

Low Risk

 Moderate Risk High Risk

1 Relative:
Over 40 years at time of diagnosis

 Reassure    

Under 40 years at time of diagnosis *

   Refer  

With bilateral breast cancer*

   Refer  

Who is male (male breast cancer) *

   Refer  

With both breast & ovarian cancer (double primary) *

     Refer

2 Relatives:
2 relatives over 60 years

 Reassure    

2 relatives (with average age) under 60 years *

   Refer  

1 under 60 years & 1 relative with ovarian cancer *

   Refer  

1 relative under 40 years and 1 relative with a childhood cancer

     Refer

3 Relatives:
Any age *

   Refer  

4 or More Relatives:
4 or more relatives under 60 years

     Refer

*One must be a first degree relative unless through an intervening male and all on the same side of
family


• 1st Degree Relative = Mother, sister, daughter, father, brother, son.

 

 

Cancer risk: ovarian cancer

(*see notes regarding first degree relatives)

 

OVARIAN CANCER  Low Risk Moderate Risk High Risk

1 Relative:
Any age

 Reassure    

2 Relatives:
Or more with ovarian cancer*

     Refer

1 relative with ovarian cancer (any age) and 1 relative with breast cancer under 50 years*

   Refer  

3 Relatives:
1 relative with ovarian cancer (any age) and 2 relatives with breast cancer under 60 yrs*

   Refer  

4 Relatives:
3 with colorectal cancer (1 under 50 years) and 1 relative with ovarian cancer*

     Refer

 

*One must be a first degree relative unless through an intervening male and all on the same side of
family


• 1st Degree Relative = Mother, sister, daughter, father, brother, son.

 

Cancer risk: colorectal cancer

(*see notes regarding first degree relatives)

 

COLORECTAL CANCER Low Risk Moderate Risk High Risk

1 Relative:
Over 50 years

 Reassure    

Under 50 years*

   Refer  

2 Relatives:
With average age under 60 years* or TWO 1st degree relatives of any age

   Refer  

3 or More Relatives:
All over 50 years*

   Refer  

With 1 diagnosed under 50 years*

     Refer

 

*One must be a first degree relative unless through an intervening male and all on the same side of
family


• 1st Degree Relative = Mother, sister, daughter, father, brother, son.

 

Editorial Information

Last reviewed: 31/01/2023

Next review date: 31/01/2028

Version: 4.1

Approved By: WoSCGS / WoSPCCN / Regional Cancer Clinical Leads Group