Session # 164

A “Minor” Problem: Hereditary Cancer Multi-Gene Panel Testing for Individuals <18. 

Genetic testing for cancer predisposition of individuals under the age of 18 (minors) is discouraged by professional statements, and should only be considered if effective medical interventions are available. At a single commercial laboratory, the majority of hereditary cancer tests ordered for minors have been limited to single site analysis for known familial mutations or single gene/syndrome tests to confirm the diagnosis of disorders that could lead to early intervention or management. However, since 2012 hereditary cancer multi-gene panel (HCMGP) testing has been available commercially to test for multiple hereditary cancer genes simultaneously. Since that time, uptake of HCMGP testing has increased due to improved time and cost-effectiveness and an increase in diagnostic yield compared to single gene testing. In contrast, concerns surrounding HCMGP testing may include higher rates of variants of uncertain significance (VUS) and, specifically for minors, incidental findings that would not lead to altered healthcare management for that child.

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