NHS Genetic Testing for Inherited Cancer Risk: Who Qualifies?

If cancer runs in your family, how do you know whether it’s something you should be concerned about? And could you qualify for genetic testing on the NHS?

Around 5–10% of cancers are thought to be linked to inherited genetic changes that increase cancer risk. And it’s not just about breast cancer or BRCA genes. Bowel, ovarian, prostate, pancreatic and several other cancers can sometimes be connected.

You may qualify for NHS genetic testing because of your own cancer diagnosis, your family history, a known genetic change in a relative or certain ancestry-related risks.

But there’s an important distinction between qualifying for a referral to a genetics service and actually being offered a test.

In this guide, I’ll explain how NHS genetic testing works, what to look for in your family history and where to find more detailed advice for different cancers.

Who qualifies for NHS cancer genetic testing?

There are several ways someone may be offered inherited cancer genetic testing through the NHS.

1. You’ve already been diagnosed with cancer

If you’ve been diagnosed with certain cancers, your hospital team may recommend inherited genetic testing.

For example, testing may be offered to people with ovarian cancer, certain types of breast cancer or bowel cancer where the tumour shows features suggesting Lynch syndrome.

These tests can sometimes help guide treatment, but they can also identify an inherited cancer risk that may be important for other family members.

2. Cancer runs in your family

You may qualify for referral to an NHS genetics service if there have been particular patterns of cancer in your family.

Doctors will consider which relatives have had cancer, how old they were when diagnosed and whether different cancers could be linked to the same inherited gene.

For example, a family history of breast and ovarian cancer, or bowel and womb cancer, may be relevant.

Importantly, your dad’s side of the family matters just as much as your mum’s.

The NHS has specific criteria for different cancers, which we’ll explore below.

3. A relative has already been found to carry an inherited cancer-risk gene

If someone in your family has tested positive for an inherited genetic change, you may be offered testing to find out whether you’ve inherited it too.

For many of the better-known inherited cancer syndromes, each child of someone carrying the genetic change has a 50% chance of inheriting it.

This type of testing is often more straightforward because doctors already know which genetic change they’re looking for.

4. You have certain ancestry-related risks

Some inherited cancer-risk variants are more common in particular populations.

For example, people with Ashkenazi Jewish ancestry have a substantially higher likelihood of carrying certain BRCA1 or BRCA2 variants, even without a family history of cancer.

NHS pathways can recognise some of these increased risks independently of family history.

There are also targeted programmes being developed for people with ancestry from Westray in Orkney and Whalsay in Shetland.

You can read more about these programmes in our NHS BRCA testing guide.

Seven signs that cancer in your family might be inherited

Most cancers aren’t caused by a single inherited genetic change. But certain patterns are worth discussing with your doctor.

These include:

1. Several relatives with the same cancer, particularly on the same side of the family.
2. Cancer diagnosed unusually young, such as breast cancer before 40 or bowel cancer at a younger age.
3. Different types of cancer that can be genetically linked, such as breast, ovarian, prostate and pancreatic cancer.
4. Someone who has developed more than one separate cancer, or cancer affecting both breasts.
5. A man with breast cancer, at any age.
6. A known inherited cancer-risk gene in your family, such as BRCA1, BRCA2 or a Lynch syndrome gene.
7. A family history of unusual cancers or particular inherited conditions, such as multiple melanomas alongside pancreatic cancer, or large numbers of bowel polyps.

These aren’t automatic criteria for genetic testing, but they can be reasons to ask for a closer look.

And remember, you don’t need to recognise every detail of your family history before speaking to your GP.

Which cancers might make you eligible for NHS genetic testing?

Different cancers have different referral and testing criteria. We’ve put together more detailed guides to explain what matters and what you can ask your doctor.

Can you have an inherited cancer risk without a family history?

Yes. And this is something I wish more people understood.

Family history is an important clue, but it isn’t a foolproof way of identifying everyone who carries an inherited cancer-risk gene.

Some families are small, people may not know their relatives’ medical history, or a genetic change may have been passed down through several people who never developed cancer.

Research suggests that traditional family-history-based criteria can miss a substantial proportion of people carrying certain inherited breast and ovarian cancer-risk variants.

Having no family history of cancer doesn’t necessarily mean you have no inherited risk.

This is one reason why some people consider private genetic testing even when they don’t meet NHS criteria.

It is also important to understand that a negative genetic test doesn’t rule out every inherited risk or eliminate the possibility of developing cancer.

Why might the NHS not offer genetic testing?

NHS genetic testing is provided according to specific clinical indications and eligibility criteria.

These vary depending on the cancer type, personal history, family history and sometimes the estimated probability of carrying an inherited gene change.

For some conditions, the NHS may first recommend assessment in a family history clinic or clinical genetics service.

A specialist may decide that genetic testing isn’t indicated under the applicable NHS pathway, even though the person has a family history of cancer.

That doesn’t necessarily mean their cancer risk is average or that no further screening is needed.

NHS eligibility criteria help determine access to publicly funded testing. They don’t provide a complete measure of someone’s individual cancer risk.

Some people who don’t qualify for testing may still benefit from additional screening or a personalised assessment of their risk.

What should I ask my GP about genetic testing?

If you’re concerned that cancer might run in your family, start by booking an appointment with your GP.

You don’t need to know which gene might be involved or arrive with a complete family tree.

You could simply say:

“There have been some cancers in my family, and I’m wondering whether there could be an inherited risk. Would it be worth referring me to a genetics service?”

Before your appointment, try to find out:

• Which relatives have had cancer, including relatives on your dad’s side.
• What types of cancer they had.
• Roughly how old they were when diagnosed.
• Whether anyone has had more than one cancer.
• Whether anyone in your family has already had genetic testing.

If a relative who has had cancer is available for testing, it may be more useful to test them first. Finding an inherited change in someone who has been affected can make testing other family members more informative.

Our guide to collecting your family history of cancer explains how to get started.

Not sure whether your family history is something to investigate?

You can also try our free inherited cancer risk checklist. It takes a few minutes and gives you personalised guidance on what to consider next.

What if you don’t qualify for NHS genetic testing?

If you’re told you don’t meet NHS criteria, it’s worth asking whether you would still benefit from a family history assessment, earlier cancer screening or another form of follow-up.

You can also consider private genetic testing.

At Coyne Medical, our doctor-led 36-gene inherited cancer panel looks for inherited changes associated with increased risks of breast, ovarian, bowel, pancreatic, prostate and other cancers.

Every patient has a doctor consultation before testing and a scheduled follow-up afterwards, whether their result is positive or negative.

The aim isn’t simply to give you a genetic report. It’s to help you understand what it means, whether there are ways to reduce your risk and what screening or specialist referrals might be appropriate.

You can also compare private inherited cancer genetic testing providers in the UK before deciding whether testing is right for you.

Finding risk earlier creates choices

At Coyne Medical, we believe that understanding your inherited cancer risk can help you make more informed decisions about your future health.

If an inherited risk is identified, there may be opportunities to start screening earlier, consider preventative treatments or arrange specialist care.

Our doctor-led genetic testing service includes a consultation before testing and a follow-up appointment to explain your results and discuss your next steps.

And you don’t need to meet NHS eligibility criteria to explore private testing.

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Clinical references

• NHS England: National Genomic Test Directory
• NICE CG164: Familial breast cancer
• NICE NG241: Ovarian cancer, identifying and managing familial and genetic risk
• NICE DG27: Molecular testing strategies for Lynch syndrome in people with colorectal cancer
• NICE DG42: Testing strategies for Lynch syndrome in people with endometrial cancer
• NHS Genomics Education Programme

Medically reviewed by Dr Lucy Hooper, Medical Director, Coyne Medical. Review date: 29th October 2026.

This guide provides general information and does not replace individual medical advice. NHS testing criteria and services may change and can differ across the UK. If you have concerns about your personal or family cancer history, speak to your GP or specialist.