Table 4.

ACMG referral indications for cancer predisposition assessment [26]

When to refer for genetic counseling:

A. Pancreatic cancer diagnosed at any age, if any of the following criteria are met.

(i) ≥2 cases of pancreatic cancer in close relatives

(ii) ≥2 cases of breast, ovarian, and/or aggressive prostate cancer in close relatives

(iii) Ashkenazi Jewish ancestry

B. Pancreatic cancer and ≥1 Peutz Jeghers type polyp in the same person

C. Pancreatic cancer and two additional cases of any Lynch Syndrome associated cancer in the same person or in close relatives

D. ≥3 cases of pancreatic cancer and/or melanoma in close relatives

E. Pancreatic cancer and melanoma in the same person

F. Unaffected but with a family history of:

(i) Ashkenazi Jewish ancestry and pancreatic cancer at any age in a close relative

(ii) three or more cases of breast, ovarian, pancreatic and/or aggressive prostate cancer in close relatives

(iii) three or more cases of pancreatic cancer and/or melanoma.