The North West Thames Regional Genetics Service (NWTRGS) is for people who are at risk of a hereditary predisposition to cancer, discusses genetic investigations and options for cancer risk management.

Consider referring patients who have been diagnosed with the following cancers if they fulfil referral criteria:

• Breast
• Ovarian
• Prostate
• Pancreatic 
• Bowel
• Endometrial
• Renal
• Endocrine
• Gastric
• Unusual tumour site or unusually young age of onset for that tumour type

If your patient or their family member has an identified genetic cancer susceptibility gene, a referral will be accepted.

The service will need a copy of the genetic test report from the family member who has been tested.

Referrals for women who are pregnant

If you are referring a woman who is pregnant, please:

• consider using the urgent prenatal query referral form (See Resources)
• include copies of relevant scan reports

Cancer genetic referral

If your patient meets the service's cancer genetic referral criteria:

• GPs can make a referral using the electronic referral system
• other specialists can email their referral using a secure nhs.net email

The referral will then be reviewed and NWTRGS may request more information from the patient by asking them to complete the patient family history questionnaire (See Resources) 

After assessing the full information, the service will either offer your patient an appointment or send them a letter containing appropriate screening advice.

Please let your patient know that it's important for NWTRGS to confirm the family history, where possible, in order to determine eligibility. Unfortunately, this can cause delay especially if there is not enough information available at the beginning of the process.

If your patient's family does not have an identified genetic cancer susceptibility gene, then NWTRGS usually only offers an appointment to someone who is affected. In some cases, where there is no affected relative available for testing, the service would consider assessing an unaffected individual. The affected relatives must be blood relations, but can be through the maternal or paternal side.

Please include any histology reports, such as receptor status or mismatch repair immunohistochemistry reports when completing the electronic referral. 

For more advice on a referral relating to cancer, please contact the team:

• by phone on 020 8869 2795, 9am-5pm, weekdays
• by email: lnwh-tr.geneticreferrals@nhs.net

Those with a strong family history of cancer may be offered an appointment for assessment in certain circumstances.

Genetics services are based on GP surgery postcode. If you are unsure which service to send your patient to, please check the Cancer Genetics Services for Each Borough document in the Downloads section. 

For information on genetics excluded conditions for referral, visit the NWTRGS website below.

Eligibility Criteria

Inclusions

Please check referral guidelines and postcodes before making a referral.

• The individual being referred should be affected with cancer (unless otherwise stated)
• All affected relatives should be on the same side of the family
• It is essential that all ages of diagnosis are specified in the initial referral
• Whenever possible, send histology for cancer diagnoses with the referral
• Adults who are at risk of carrying a mutation in a cancer predisposition gene which has been identified in a relative should be referred
• Fulfilling the referral criteria does not mean a person will be seen in the genetics clinic

How to Refer

Locations

North West Thames Regional Genetics Service