The American College of Medical Genetics Professional Practice and Guidelines Committee and the National Society of Genetic Counselors Practice Guidelines Committee (NSGC) reviewed and reaffirmed this document with the following comment: The committees feel that this document remains a useful guide in assessing indications for cancer referral; however, it should not be considered comprehensive nor utilized to limit access to genetics professionals. While the principles outlined for genetics referral for the specific tumors and syndromes listed remain valid, in many cases the indications for referral have expanded. The field of cancer genetics is rapidly evolving, including frequent discovery of additional genes and new clinical presentations, expanded gene panel testing, paired tumor and germline sequencing, and expanded utility of molecular testing in treatment planning. These changes have impacted referral considerations outlined in this document. We encourage clinicians to consult additional updated sources in making final decisions regarding referral. These include more recent versions of the National Comprehensive Cancer Network guidelines ( and GeneReviews ( Additionally, we recognize increasing need for all health care providers to collaborate to meet the clinical care needs of individuals known or suspected to be impacted by a hereditary cancer condition, and the evolving role of non-genetics professionals in this area.

In accordance with current policy, this document is now classified as a Practice Resource by the NSGC.