Familial Melanoma Genetic Testing: NHS Assessment
Most melanomas aren’t caused by an inherited high-risk gene change. But if several relatives have had melanoma, someone has developed more than one, or melanoma occurs alongside pancreatic cancer, it’s worth discussing whether the pattern needs a closer look.
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Is melanoma inherited?
Most melanomas aren’t caused by an inherited cancer gene. The biggest preventable risk factor is exposure to ultraviolet (UV) radiation from sunlight and sunbeds.
However, some people are naturally at higher risk than others. According to the British Association of Dermatologists, factors that increase melanoma risk include:
- Having fair skin that burns easily, freckles or red hair.
- Having lots of moles, particularly large or unusual-looking ones.
- A history of severe sunburn, especially during childhood.
- Having previously had a melanoma.
- Having a weakened immune system.
- Having a family history of melanoma.
Around 10% of melanomas may be linked to inherited genetic risk.
But having a relative with melanoma doesn’t automatically mean you carry a high-risk gene. Families often share other risk factors, including skin type and sun exposure.
In a smaller group of families, changes in genes such as CDKN2A can substantially increase the risk of melanoma. Some inherited genetic changes can also increase the risk of other cancers, particularly pancreatic cancer.
This is why the number of relatives affected, their ages at diagnosis and whether there have been other cancers in the family can help doctors decide whether genetic testing might be useful.
When should you be concerned about a family history of melanoma?
Having one relative with melanoma doesn’t necessarily mean there’s an inherited genetic risk. But certain patterns in your family history are worth discussing with your doctor:
- Two or more close relatives with melanoma, particularly on the same side of the family.
- Several melanomas in one person, especially separate primary melanomas rather than a recurrence.
- Melanoma diagnosed at a young age, particularly alongside other affected relatives.
- A family history of both melanoma and pancreatic cancer, which can sometimes be linked to inherited changes in genes such as CDKN2A.
- A known inherited melanoma-risk gene variant in your family.
These are reasons to take a closer look, not automatic criteria for NHS genetic testing.
If any of these apply to you, it’s worth speaking to your GP about whether a dermatology or clinical genetics referral would be appropriate.
Why does pancreatic cancer matter?
Some inherited changes in a gene called CDKN2A can increase the risk of both melanoma and pancreatic cancer.
That’s why it’s worth mentioning any family history of pancreatic cancer to your doctor, even if you’re asking about melanoma. Having both cancers in a family doesn’t necessarily mean there’s an inherited risk, but it may be worth investigating.
Who should be tested first?
If several people in your family have had melanoma, it’s usually best to start by testing someone who has actually had the cancer.
This is because we’re more likely to find an inherited genetic change in someone who has been affected.
If a genetic change is found, other family members can then be tested to see whether they’ve inherited it too.
If testing an affected relative isn’t possible, you can still ask your GP whether a genetics referral would be helpful.
What should I ask my GP?
You could simply say: “Several people in my family have had melanoma, and I’m wondering whether there could be an inherited risk. Would it be worth referring me to a specialist?”
Try to bring along details of which relatives have had cancer, what type of cancer they had and roughly how old they were when diagnosed. If anyone has had melanoma more than once, mention that too.
What if I do not qualify?
Whatever your genetic test results, protecting your skin from the sun and getting any new or changing moles checked remains important.
If you’re at higher risk of melanoma, your doctor may also recommend regular skin checks with a dermatologist, even if genetic testing doesn’t find an inherited risk.
Don’t wait to get a changing mole checked
If you notice a new or changing mole, or a patch of skin that looks unusual, don’t wait for genetic testing. Make an appointment with your GP to have it checked.
Melanoma can develop in people with no family history or inherited genetic risk. Finding it early is important because treatment is usually much more successful before it has spread.
Frequently Asked Questions
No. Having a parent who has had melanoma increases your risk, but it doesn’t mean you’ll develop it yourself.
Most melanomas aren’t caused by a single inherited gene change. Families can also share risk factors such as fair skin, a tendency to burn and sun exposure.
It’s worth telling your GP about your family history, particularly if other relatives have also had melanoma.
Yes. Inherited cancer-risk genes can be passed down through either parent.
Your dad’s family history is just as important as your mum’s. And a person can carry an inherited genetic change without ever developing melanoma themselves.
When looking at your family history, remember to include grandparents, aunts and uncles on both sides.
Not necessarily. Having lots of moles, particularly unusual-looking ones, is a recognised risk factor for melanoma, but it doesn’t automatically mean you carry an inherited cancer gene.
If you have many moles, a history of abnormal moles or a family history of melanoma, it’s worth asking whether you would benefit from a dermatologist assessing your skin.
Any new or changing mole should be checked, regardless of your genetic risk.
Yes. You don’t need a family history of melanoma or any other cancer to consider private inherited cancer genetic testing.
Although certain patterns of cancer in a family can suggest an inherited risk, family history alone doesn’t identify everyone who carries a harmful genetic change. Sometimes families are small, information about relatives is missing, or people carrying a genetic change simply haven’t developed cancer.
NHS genetic testing is generally offered to people who meet specific eligibility criteria. At Coyne Medical, we also offer inherited cancer genetic testing to people without a family history who would like to understand more about their risk.
A consultation before testing helps you understand what the test can and cannot tell you, and whether it’s likely to be useful for you.
A negative result can be reassuring, but it doesn’t mean you have no risk of melanoma.
Not every inherited melanoma risk can currently be identified through genetic testing. Your skin type, previous sun exposure, number of moles and family history still matter.
You may still benefit from regular skin checks, depending on your individual circumstances.
Finding out you’re at higher risk doesn’t mean you’ll develop melanoma. But it can help you take steps to protect your health.
These might include regular skin examinations with a dermatologist, checking your own skin, protecting yourself from UV exposure and avoiding sunbeds.
Some inherited gene changes, particularly CDKN2A, can also increase pancreatic cancer risk. In certain circumstances, specialist pancreatic surveillance may be considered, or regular eye examinations to spot uveal melanoma.
Your doctor can help you understand which steps are appropriate for you.
Yes. Some inherited genetic changes can increase the risk of more than one type of cancer.
For example, changes in a gene called BAP1 can increase the risk of melanoma affecting the eye (uveal melanoma), as well as mesothelioma, a rare cancer affecting the lining of the lungs or abdomen.
These cancers are uncommon, and most cases aren’t caused by an inherited gene change. However, if someone in your family has had one of these cancers, particularly alongside melanoma or other unusual cancers, it’s worth mentioning this to your doctor.
What should you do if melanoma runs in your family?
If you’ve noticed several cases of melanoma in your family, or melanoma alongside other cancers such as pancreatic cancer, it’s worth finding out whether there could be an inherited risk.
Start by looking at your family history. Try to find out which relatives have had melanoma, how old they were when diagnosed and whether anyone has had more than one melanoma.
You can then discuss this information with your GP, who can advise whether a dermatology or genetics referral might be useful.
Find out how to collect your family cancer history
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 health.
Our doctor-led inherited cancer genetic testing service includes a consultation before testing and a follow-up appointment to explain your results, discuss ways to reduce your risk and arrange further screening or specialist referrals where appropriate.
Even if no inherited genetic change is found, we’ll consider your family history and what it might mean for your future health.
DR LUCY HOOPER
MB BS BSc MRCGP MA DRCOG DCH
Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.
British Society for Genetic Medicine · European Atherosclerosis Society ·
Independent Doctors Federation
As seen in BBC, The Guardian, Women’s Health, The Times and Tatler
For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.
Genetic testing referrals for healthcare professionals
If you are a dermatologist, plastic surgeon or other clinician caring for patients concerned about inherited melanoma risk, we can help you offer an inherited cancer risk assessment, including to people who do not meet NHS or insurer testing criteria.
Our comprehensive 36-gene inherited cancer panel includes CDKN2A, CDK4, BAP1 and POT1 (the four genes on the NHS R254 familial melanoma panel), alongside MITF, BRCA2 and PTEN. Testing is performed by Nonacus Clinical Services, a UK-based laboratory that also supports NHS hereditary cancer services. Nonacus hereditary cancer service as accredited to ISO 15189:2022.
Patients have a physician consultation before testing and a scheduled results consultation, whatever their result. We discuss relevant screening and risk-reduction options, coordinate NHS or private specialist referrals where appropriate and, with patient consent, communicate with the referring clinician. We already work with consultants who want to offer this pathway to their patients.
For referral enquiries and details of our testing pathway for healthcare professionals read more here.
Clinical references
NHS Genomics Education skin cancer: https://www.genomicseducation.hee.nhs.uk/genotes/in-the-clinic/patient-with-a-family-history-of-skin-cancer/
NHS Genomic Test Directory: https://www.england.nhs.uk/publication/national-genomic-test-directories/
Information prepared 28 October 2026. This page is for general information, not personal medical advice or a consultation. Discuss your family history, personal screening and medical decisions with your own doctor or healthcare team. NHS pathways and criteria may change and differ across UK nations.