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Making a referral to cancer genetics

Making a referral to clinical genetics is different to making a referral for genetic testing. An assessment by clinical genetics will require a formal referral to our service, as below. Genetic tests can be sent directly according to the National Genomic Test Directory. Sending a sample for genetic testing will not result in an automatic referral to the clinical genetics service, which will need to be made independently if required.

We prefer referrals via email: Cancer.Genetics@stgeorges.nhs.uk or via ERS. We also accept written referrals by post.

If you have any queries or are uncertain if a referral is appropriate, please contact us via Electronic Referral System (ERS) for advice and guidance, or through: Cancer.Genetics@stgeorges.nhs.uk

NOTE: Genetic testing is ALWAYS most informative in an individual affected with cancer. Please refer affected individuals to our service over their unaffected relatives wherever possible

We will accept any referrals for:

  • Patients meeting National Genomic Test Directory Criteria for inherited cancer genetic testing
  • Patients with a relative who has a likely pathogenic or pathogenic variant in a known cancer predisposition gene who require predictive testing. A copy of the relatives report or ‘relatives letter’ is preferred for these referrals where possible.
  • Patients who are known to carry a likely pathogenic, pathogenic variant or variant of uncertain significance in a known cancer predisposition gene identified in mainstream genetic testing
  • Patients who are known to carry a likely pathogenic or pathogenic variant identified in genetic testing elsewhere (such as the private sector or when living out of area)
  • Patients at high risk of developing cancer due to their personal and/or family history. Please see our guide to assessing eligibility for assessment.

All referrals should be sent with sufficient detail and documentation to assess eligibility for a genetic appointment. All information required is outlined in the relevant section of the cancer genetics referral form:

Please note we will reject referrals with insufficient information.

Ordering a cancer genetic test

Patients who meet National Genomic Test Directory Criteria for inherited cancer/tumour genetic testing may be offered testing directly by their treating team in secondary care according to the test directory guidelines. This is known as “mainstreaming”.

Any cancer patient who has had a potentially disease causing genetic variant identified in their tumour which might also be inherited should have this confirmed by germline testing.

We have developed a suite of resources to support clinicians who wish to undertake genetic testing themselves. Both general and indication specific resources are below:

General resources

Patients who have had mainstream testing and a germline variant has been identified can be referred directly by sending a copy of their genetic test report and a completed  cancer genetics referral form.

Tumour type specific resources

All information about genetic testing eligibility for different tumour types can be found in the National Genomic Test Directory.

A detailed guide for genetic testing in many tumour types can also be found through GeNotes oncology and endocrinology sections.

Requesting advice from the cancer genetics team

We have a dedicated cancer genetics on call service available for advice from our clinicians.

This service runs 09.00am-17.00pm Monday-Friday.

We can be contacted on:

Email: Cancer.Genetics@stgeorges.nhs.uk
Telephone: 020 8725 5333

Rapid referral for r208 testing- update May 2024

From 01/06/2024, R208 germline genetic testing for affected breast cancer patients will need to be mainstreamed (breast clinical team discuss, request, receive and deliver genetic testing). Current turn around time for R208 testing is 4-6 weeks.

If you require the R208 to be done sooner than this time-frame please email genomic.services@stgeorges.nhs.uk after you have sent the test request form with a clear clinical reason why testing is required on a more urgent basis and the date the change in clinical management will occur.

If testing is not going to affect patient management and can be done in a routine manner, then we will still accept referrals for routine review (3-6 month waiting time for initial appointment).

Instead of accepting rapid referrals, we will be running a Monday-Friday 9-5 genetic counsellor helpline for any concerns, queries or support required, via 02087255333

This change is required due to significant issues with the new pathway affecting clear, quick return of results for all breast cancer patients.

Link to patient information sheet about diagnostic genetic testing:

Patient Information Sheet 

Link to genetic blood test request form:


Link to “Record of discussion form”:

Non-WGS-RoD-v1.1.pdf (southeastgenomics.nhs.uk)