OHSU Knight Cancer Institute

Genetic Counseling and Risk Assessment

At the Knight Cancer Institute, we’re committed to helping you lower your cancer risk.

For some patients, this involves genetic counseling and testing. Our medical geneticists and genetic counselors can guide you through options and help you decide next steps.

Understanding genetic risk

A genetic counselor explaining genetic risk to a patient.
Dr. Jone Sampson is an OHSU medical geneticist who focuses on cancer.

Some cancers run in families because members pass a gene that has a defect, or mutation, from one generation to the next. These genes play a role in about 5-10% of cancers.

If you have such a gene, it does not mean you will definitely get cancer. It means only that your risk is higher.

Once you know, you can take steps to lower your risk and to increase screening for early detection.

It’s also important to understand that cancer can run in families because of environmental factors  such as smoking or too much sun exposure  that have nothing to do with inherited traits.

Family history

A genetic mutation might be suspected in a family:

  • With several members having the same cancer.
  • With a member who has had more than one type of cancer.
  • With rare cancers, such as ovarian or male breast cancer.
  • With cancer in people younger than 50.
  • In an ethnic group with a higher risk of having a mutation.

Inherited cancers

Researchers have identified more than 50 hereditary cancer syndromes. Types include:

In this syndrome, also called HBOC, the BRCA1 and BRCA2 genes are linked to an increased risk of:

  • Breast cancer
  • Ovarian cancer
  • Pancreatic cancer 
  • Prostate cancer

This syndrome is also called hereditary nonpolyposis colorectal cancer, or HNPCC. It increases the risk of:

  • Colorectal cancer
  • Uterine cancer

Other associated cancers include:

  • Bile duct cancer
  • Brain tumors
  • Cancer of the small intestine
  • Kidney cancer
  • Liver cancer
  • Ovarian cancer
  • Pancreatic cancer
  • Stomach cancer
  • Urinary tract cancer

This syndrome, also called FAP, can cause polyps to develop in the colon and rectum, significantly increasing the risk of colorectal cancer. A milder form is called attenuated familial adenomatous polyposis, or AFAP.

People with Cowden syndrome are likely to develop noncancerous growths called hamartomas on the skin or inside the body. They also have a higher risk of:

  • Breast cancer
  • Thyroid cancer
  • Uterine cancer.

Li-Fraumeni syndrome is a rare condition that increases the risk of cancer, especially at a young age. Cancer types associated with this syndrome include:

  • Adrenal cancer
  • Breast cancer
  • Brain tumors
  • Leukemia
  • Osteosarcoma, a type of bone cancer
  • Sarcoma

People with this syndrome can develop noncancerous tumors such as hemangioblastomas, which form from blood vessels in the brain, spinal cord and eye. They are also at higher risk of:

  • Adrenal cancer
  • Kidney cancer
  • Pancreatic cancer

This group of disorders involves tumors in glands that produce hormones, such as the thyroid and pituitary glands. Tumors can be noncancerous or cancerous.

What to expect

The OHSU Knight Cancer Institute is the only Oregon cancer center with board-certified medical geneticists specifically trained to determine the risk of hereditary cancer syndromes. Our medical geneticists and genetic counselors will:

  • Review your family history and/or your history of cancer
  • Discuss cancer genetics and testing options
    • Coordinate testing, if needed
    • Review insurance, if needed
    • Arrange follow-up to review results
  • Conduct an individual risk assessment
  • Talk with you about ways to lower your risk, such as:
    • Screening
    • Lifestyle changes such as getting exercise and stopping smoking
    • Preventive options, such as mastectomy for someone at high risk of breast cancer

Our team

Medical geneticists

Genetic counselor

Learn more

For patients

Call 503-494-4800 to:

  • Request an appointment
  • Seek a second opinion
  • Ask questions


Parking is free for patients and their visitors.

Center for Health & Healing Building 2
3485 S. Bond Ave.
Portland, OR 97239
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