Unlocking Clues to Your Whole Health
Just like your looks and behaviors, genes that affect your health can also be passed down in families. And they’re often a mystery. But what if you could learn more about these genes and whether they put you at risk for certain cancers or other genetic conditions?
With advanced genetic counseling and testing services, we can help you do just that at AdventHealth. Throughout our Colorado network, our genetic counselors offer virtual and in-person visits for your convenience.
Our genetic counselors will work with you to understand what your results mean for you and your family, making the treatment you get completely personalized to you.
We’re here to help you find the right genetic counselor or a location that’s convenient for you.
When It Comes to Your Health, Knowledge Is Power
Genetic testing can often give you a clear view of your health, from a disease you know you have to conditions that may not yet be diagnosed. Your doctor can use insights from genetic testing to truly personalize your health care and help prevent, diagnose and treat serious health risks.
- Getting Started With Genetic Counseling
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Genetic counseling is the first step in the genetic testing process. And since we’ll ask you about your personal health and family history at your appointment, it can be helpful to talk to your relatives beforehand to be sure you have the most accurate and complete information possible about your family’s health.
After you answer questions, your genetic counselor will estimate your risks for certain diseases, including cancer. They’ll also talk through any next steps and make sure you have all the details you need to decide what’s right for you based on your specific concerns.
- Support and Guidance From Experienced Genetic Counselors
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Learning about your genetics is fascinating. But it also can be a little confusing. The good news is that we’re experts, and we’re here to support you.
Our genetic counselors will:
- Help you decide if genetic testing is right for you
- Review the benefits and limits of genetic testing
- Estimate your risk for certain diseases, including your risk of inheriting cancer
- Find ways to screen and prevent cancer based on your risks
If you proceed with genetic testing, your genetic counselor can coordinate it for you
- Smart Prevention With a Range of Genomics Services
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Genomics services may or may not be helpful to you and your situation. In fact, they’re often reserved for people who’ve been diagnosed with cancer, have a family history of cancer or have health conditions that may be related to genetics — conditions like cardiomyopathy or hemochromatosis. But ultimately, it’s up to you if you want genetic counseling or testing.
We offer a full range of genomics services, including:
- Carrier screening
- Genetic counseling (including pre-test and post-test)
- Genetic test coordination
- Genetic testing
- Hereditary cancer risk assessment
- Preconception genetic counseling
And if your genetic counseling reveals a health condition, rest assured that we’ll build a treatment plan tailored to your unique needs. We treat inherited diseases like:
- Genetic disease
- Hereditary cancer
- Hereditary cardiovascular disease
- If I tested negative in the past, do I need to retest?
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Maybe. Genetic testing for inherited cancer syndromes has been significantly updated in recent years and individuals may qualify for additional genetic testing even if they tested negative in the past. Our genetic counselors can determine if you need additional genetic testing by assessing your previous results and personal and family history.
Multi-Gene Panels
Before 2012, genetic testing done for hereditary cancer syndromes was often completed one gene or one syndrome at a time. Since 2012, technology has improved to be able to test many different genes at once. We now call these tests “panels” since they analyze a large panel of genes at one time. These panels have made genetic testing cheaper because now one test can be done to test someone for numerous genes of concern at once instead of having to order multiple tests from multiple labs. Panels also allow us to test individuals for rare hereditary cancer syndromes that we previously would not have been able to receive insurance coverage for. Modern hereditary cancer panels typically cover over 40 genes.
BRCA1 and BRCA2
BRCA1 and BRCA2 have been the center of conversations surrounding hereditary breast cancer since the mid-1990s. BRCA1/2 testing that was done before 2012 did not always include comprehensive rearrangement testing so it is very possible that individuals who received normal BRCA1/2 test results before 2012 could still have a BRCA1 or BRCA2 mutation that was undetected at the time.
Other Hereditary Breast Cancer Genes
In addition, many different genes have long been known to interact with BRCA1 and BRCA2. Studies have now shown that individuals with mutations in these other genes also have an increased cancer risk. Testing for these additional genes is now available as part of the genetic testing panels available.
Hereditary Colon Cancer and Lynch Syndrome
Hereditary colon cancer has also seen great advances. The most frequently identified hereditary colon cancer syndrome is Lynch syndrome, which leads to an increased risk for colon, uterine and other cancers. Additional genes that cause Lynch syndrome have been identified and more comprehensive testing of these genes is also now available. New causes of hereditary colon cancer have been identified as well. Individuals who received normal Lynch syndrome testing in the past could still have a mutation that was not detected at the time or have a mutation leading to another hereditary colon cancer syndrome that was not tested.
Other Hereditary Cancers
For patients with other cancer types, we now have testing options that did not exist previously. For example, there are now tests available that test for numerous genes for hereditary kidney cancer and hereditary pancreatic cancer.
Genomics and Risk Assessment for Cancer Early Detection (GRACE) Program
It’s well established that having pathogenic variants in BRCA 1/2 (and other genes) puts individuals at a much higher risk of developing hereditary cancers, primarily breast and ovarian cancers.
There are also several genes associated with a higher risk of developing gastrointestinal and colorectal cancer, including the Lynch syndrome. Those with Lynch syndrome are at a higher risk of developing other cancers, such as uterine, stomach, liver, kidney and brain cancers, at a young age (less than 50 years old).
Personalized Recommendations Based on Your Family History and Genetics
Our GRACE Program is here to help you feel informed about your cancer risk. Patients scheduling their annual mammography screening appointments (at a participating site) will be provided a cancer risk assessment to complete as part of their appointment check-in process.
Patients who complete the cancer risk assessment will be contacted by our scheduler to see if you would be interested in scheduling a genetic counseling appointment to learn more about your risk. If you are at high-risk, you may receive:
- High-risk surveillance pathways
- Genetic testing and genetic counseling
- Cascade testing for your family
What to Expect During Your Screening
Watch the videos below to learn more about how we're pairing a genetic risk assessment with your regular screenings, and what you can expect.
Natera Empower | AdventHealth
Clinical Genomics: Breast Health RMR
Frequently Asked Questions
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Q:Question: Why are we offering clinical genetic testing programs, such as the GRACE program?
A:Answer:From disease prevention to diagnosis to treatment, genomics is the future of medicine. Genomics will be an essential component of health care not just for individuals, but for our greater community as we focus on wellness and preventative care. The implications of genomics programs are significant for today’s patients, and importantly, the future of Colorado’s collective health.
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Q:Question: Who can join the program?
A:Answer:Adults who are scheduled for a mammography appointment within AdventHealth can join the program. Once you have an appointment at one of these locations, you will receive an email to complete a cancer risk assessment survey. This is the first step of the program.
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Q:Question: How do I join the program?
A:Answer:You will provide your family history via your MyChart questionnaire or at your mammography appointment. Our scheduler will call you to see if you would like to schedule a genetic counseling appointment if you may be at a higher-than-average risk for cancer.
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Q:Question: Why are you looking at cancers that may have a hereditary cause, like breast and colon cancers?
A:Answer:It’s well established that having pathogenic variants in BRCA 1/2 (and other genes) puts individuals at a much higher risk of developing hereditary cancers, primarily breast and ovarian cancers.
There are also several genes associated with a higher risk of developing gastrointestinal and colorectal cancer, including the Lynch syndrome. Those with Lynch syndrome are at a higher risk of developing other cancers, such as uterine, stomach, liver, kidney and brain cancers, at a young age (less than 50 years old).
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Q:Question: Why is early detection so important?
A:Answer:Early detection of cancer is associated with better health outcomes and lower cost of care to the patient. Additionally, if genetic testing shows that a patient has a higher chance of developing cancer, that gives the patient the opportunity to let their relatives know about their potential to carry the same hereditary cancer predisposition syndrome.
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Q:Question: If I tested negative a long time ago, do I need to retest?
A:Answer:Maybe. Genetic testing for inherited cancer syndromes has been significantly updated in recent years and individuals may qualify for additional genetic testing even if they tested negative in the past. Our genetic counselors can determine if you need additional genetic testing by reviewing your previous results and personal and family history.
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Q:Question: If I have increased risk for cancer, could I pass it on to my children?
A:Answer:For most hereditary cancer conditions, if you are found to have a mutation, each of your children would have a 50% chance of having the same mutation or condition.
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Q:Question: Will I be billed for genetic counseling?
A:Answer:Genetic counseling visits are billed like other visits to medical professionals. Commercially insured individuals who have not had cancer themselves and are seen due to a family history of breast or ovarian cancer often have genetic counseling as a preventative service that is 100% covered. Self-pay rates are available to individuals who do not have coverage of genetic counseling services.
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Q:Question: Will I be billed for genetic testing?
A:Answer:If you see one of our genetic counselors and decide to pursue genetic testing, you will be billed in the same manner as other lab tests that are medically recommended and ordered by your physicians. The majority of patients pay $100 or less out of pocket. If you have a high deductible or you self pay, the genetic testing self-pay price is about $250. Most laboratories have patient assistance programs if you cannot afford the cost.
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Q:Question: If genetic testing indicates a potential “pre-existing condition,” will it affect my chances of obtaining insurance in the future?
A:Answer:A federal law called the Genetic Information Nondiscrimination Act (GINA) makes it illegal for health insurance companies, group health plans, and most employers to discriminate against you based on your genetic information, but GINA does not apply to life insurance, long-term care insurance, or disability insurance. More information about GINA is available at http://www.genome.gov.
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Q:Question: Are you going to sell my DNA information to other companies?
A:Answer:No, we are not going sell your DNA information to other companies.
Your DNA analysis test results and other health information about you may be used and shared with others as allowed by federal and state privacy laws for:
- Treatment you receive from health care providers
- Payment to AdventHealth, your physician(s) and the laboratory by health plans or other payers for your treatment
- Health care operations of AdventHealth, your physician(s) or the laboratory, such as reviewing what went well with your treatment and what needs to be improved, as well as creating de-identified information that may be used and shared with others as allowed by law
Please review the AdventHealth Joint Notice of Privacy Practices for more details about how your health information may be used and shared with others and how you may request restrictions.
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Q:Question: Who may I speak with if I have further questions regarding genetic testing?
A:Answer:Speak with your physician or genetic counselor who is performing your procedure or ordering the DNA analysis test. If you have additional questions about the clinical program, please contact our GRACE program coordinator at 303-269-4348.
Experience Health Care Tailored to You
When we say we’re here to give you personalized treatment, we mean it. And that sometimes starts with understanding what makes you, you. What genes do you have that put you at risk for cancer or other conditions? What screenings are especially important for you? What treatments will work best at treating your specific disease? Let’s find the answers, together.