Clinical Prioritisation Criteria

Genetics Cancer

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
No referrals to emergency relating to clinical genetics
Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.
Breast cancer genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Colorectal or small bowel cancer genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Dermatological cancer or tumour (AFF): Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Endocrine cancer or tumour genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Family history: Individual with a family history of cancer from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Female gynaecological cancer or tumour genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Gastrointestinal polyps (not cancer) genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Gastric cancer genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Haematological malignancy genetics - Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Individual who has undergone mainstreamed, research or private genetic testing for cancer predisposition genes ADULT PAEDIATRIC
Musculoskeletal or soft tissue tumour or cancer: relating to cancer genetics ADULT PAEDIATRIC
Neurological or ocular tumour or cancer: Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Paediatric or adolescent and young adult (AYA) cancer genetics- Affected individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified PAEDIATRIC
Pancreatic or biliary tract tumour or cancer: Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Respiratory or oropharyngeal tumour or cancer: Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
Untested blood relative of a person with an identified mutation in a cancer predisposition gene ADULT PAEDIATRIC
Urological tumour or cancer: Individual from a family in whom a mutation in a cancer predisposition gene has NOT been identified ADULT PAEDIATRIC
The following are not routinely provided in a public Genetics Cancer service.
Cancer Genetics
Individuals with a personal history of colorectal cancer diagnosed at age ≥ 40 years with loss of MLH1 and PMS2 on mismatch repair immunohistochemistry AND presence of the BRAF V600E mutation in tumour AND have no other personal or family history suggestive of a familial predisposition to colorectal cancer or gastrointestinal polyps.  For further information please see Colorectal Cancer condition within Genetics CPC and MMR IHC document on the GHQ website.
Individuals with a personal history of colorectal cancer diagnosed at age ≥ 40 years with normal mismatch repair immunohistochemistry AND have no other personal or family history suggestive of a familial predisposition to colorectal cancer or gastrointestinal polyps.  For further information please see Colorectal Cancer condition within Genetics CPC and MMR IHC document on the GHQ website.
Individuals with a personal history of endometrial cancer diagnosed at age ≥ 50 years with loss of MLH1 and PMS2 on mismatch repair immunohistochemistry AND presence of MLH1 promoter methylation in tumour AND have no other personal or family history suggestive of a familial predisposition to endometrial cancer.  For further information please see Female gynaecological cancer or tumour condition within Genetics CPC and MMR IHC document on the GHQ website.
Individuals with a personal history of endometrial cancer diagnosed at age ≥ 50 years with normal mismatch repair immunohistochemistry AND have no other personal or family history suggestive of a familial predisposition to endometrial cancer.  For further information please see Female gynaecological cancer or tumour condition within Genetics CPC and MMR IHC document on the GHQ website.
Individuals with melanoma who do NOT fulfil the following criteria:
2 or more affected first or second degree relatives AND a 4 factor GenoMEL probability of a CDKN2A mutation of ≥20%
BAP1 deficiency on immunohistochemistry
Individuals who are solely being referred due to a family history of melanoma
Individuals who are solely being referred due to a family history of pancreatic cancer who do NOT fulfil one of the following criteria:
Three or more relatives with pancreatic cancer, at least one of whom is a first degree relative.
At least two first degree relatives with pancreatic cancer
Individuals with a family history of cancer who are solely being referred for further assessment and management of a suspected new cancer (e.g. elevated tumour markers, abnormal breast imaging).
Individuals at increased risk of cancer who are solely being referred for ongoing management of cancer risk such as surveillance or risk reducing surgery.
Individuals solely being referred due to a personal and/or family history of cancer which is unlikely to be associated with a familial cancer predisposition syndrome or increased risk of cancer for unaffected family members.
Individuals solely being referred due to a family history of prostate cancer.
Individuals who are not residents of Queensland.
Individuals solely referred for a family history of bowel cancer who do NOT fulfil one or more of the following criteria:
At high lifetime risk of bowel cancer according to NHMRC guidelines
Individuals solely referred for a family history of breast cancer who do NOT fulfil one or more of the following criteria:
fits in the high (substantially increased) lifetime risk category according to iPrevent, Tyrer-Cuzick or CanRisk
Two 1 degree or 2 degree relatives on one side of the family diagnosed with breast or ovarian cancer plus one or more of the following features on the same side of the family:
breast cancer diagnosed before the age of 40, bilateral breast cancer, breast and ovarian cancer in the same women, Jewish ancestry, breast cancer in a male relative

Last updated: 16 July 2021

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