Colorectal cancer (CRC) is common, affecting approximately 140,000 individuals annually in the United States. The average person has a 5% lifetime risk to develop CRC. As with all cancers, CRC develops due to a combination of genetic, biologic, and environment factors interacting together. Approximately 5 - 10% cases of CRC are due to a hereditary syndrome, where a single gene alteration conveys a high risk of CRC and sometimes other cancers. The resources below provide opportunities to learn about hereditary colorectal cancer syndromes, how to use family history to assess risk level, genetic testing, using genetic information to inform management, and communicating with patients about genetic risk.

About colorectal cancer

Lynch Syndrome. Clinical features, diagnosis, testing and genetics of Lynch syndrome.

Familial Adenomatous Polyposis Syndrome. Clinical features, diagnosis, testing and genetics of Familial Adenomatous Polyposis syndrome. 

Genes and cancer risks associated with syndromes. Key features and cancer risks associated with common hereditary cancer syndromes.

Clinical resources

Targeted colorectal and polyp family history. Provides guidance in collecting a family history targeted toward colorectal cancer.

Cancer risk assessment. Identify red flags and stratify cancer risk based on family history.

Colorectal cancer screening guidelines. Summarizes professional society guidance about screening for individuals at average, increased, and high risk of colorectal cancer.

Hereditary cancer management guidelines. Lists and links to evidence-based guidelines and professional society publications that address management of hereditary and familial cancer. 

Genetic testing methods. Enhanced e-book available for download that provides information about different genetic testing methods currently used in testing for hereditary cancer syndromes. (free)

Communicating risk. Key points to consider when communicating risk to patients.

Pretest counseling. Key points to address during pre-test counseling session.

Components of a cancer genetic counseling session. Discusses the core components of a cancer genetic counseling session.

Accessing genetic services. Find genetics professionals and communicate with patients about a genetics referral.

Cancer genetic services in Maine and Connecticut. Listing of available cancer genetics services in Maine and Connecticut

Ethical, Legal, and Social Issues

GINA resource. The Genetics Information and Nondiscrimination Act (GINA) protects individuals from the misuse of genetic information in health insurance and employment. This overview provides information about the law.

Courses

Genetic testing for colorectal cancer risk. Self-directed, 15-minute online program about evaluating the fit between a patient's history and a particular genetic test for hereditary colorectal cancer syndromes. (free CME available)

Collecting family history. Self-directed, 15-minute online program about asking the right questions to elicit enough information to assess family history disease risk. (free CME available)

Categorizing cancer risk. Self-directed, 15-minute online program that provides opportunity to learn and practice how to analyze family histories and classify the patients' risk into average, increased (or moderate), or high risk for cancer. (free CME available)

Using family history to inform management. Self-directed, 15-minute online program about determining appropriate management based on family history risk using available guidelines. (free CME available)

Identifying red flags and patterns that increase risk. Self-directed, 15-minute online program about Identifying genetic red flags and patterns in a family medical history that can help determine if a condition has a significant genetic contribution. (free CME available)

Pre-test decisions & counseling. Self-directed, 15-minute online program about deciding when and if genetic testing is appropriate, given the clinical and personal context. (free CME available)

Interpreting genetic testing results. Self-directed, 15-minute online program about interpreting genetic testing results within a patient’s specific context. (free CME available)

Genetic testing technology. Self-directed, 15-minute online program about weighing the benefits, risks, and limitations of different tests within specific patient contexts. (free CME available)