Complete This Questionnaire to Assess Your Hereditary Cancer Risk

This brief questionnaire will help you learn about whether you should get more information about hereditary cancer from a healthcare provider. On average, the quiz takes less than 1 minute to complete.

Please include information about both your biological mother's and biological father's sides of the family when answering questions. You will be asked about the following cancers/conditions in your family:

  • Breast Cancer
  • Ovarian/Fallopian Tube/Peritoneal Cancer
  • Colorectal Cancer
  • Uterine/Endometrial Cancer
  • Pancreatic Cancer
  • Thyroid Cancer
  • Prostate Cancer
  • Kidney Cancer
  • Stomach Cancer
  • Adrenocortical Carcinoma
  • Brain Tumors
  • Sarcomas
  • Paraganglioma/Pheochromocytoma

Frequently Asked Questions

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Genetic discrimination is when someone is treated differently by others (like an insurance company) based on his/her genetic information. Learn more about this possibility in this video:

These questions are based on established clinical guidelines for referrals to specialized healthcare providers to discuss a personal and/or family history of cancer. A referral will help you learn whether you should have further evaluation (including genetic counseling) and consider genetic testing. This questionnaire will help determine if you may have an increased risk for hereditary cancer, so that you can be more prepared when you talk to your healthcare provider about the possibility of learning more through a referral.


Disclaimer: These questions are based on established clinical guidelines for referrals to specialized healthcare providers to discuss a personal and/or family history of cancer. A referral will help you learn whether you should have further evaluation (including genetic counseling) and consider genetic testing. This questionnaire will help determine if you may have an increased risk for hereditary cancer, so that you can be more prepared when you talk to your healthcare provider about the possibility of learning more through a referral.