Virtual Family History Service
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The Virtual Family History Service is a regional service offering cancer family risk assessment throughout the South West Thames and Surrey and Sussex regions to individuals with a family history breast, ovary and bowel cancers.
The aim of the service is to improve the surveillance, prevention, and early detection of cancer, primarily for those unaffected by cancer with a family history.
We use the cancer risk assessment tool CanRisk to map risk and screening recommendations to NICE CG164 guidance for patients with a family history of breast cancer and NICE NG241 guidance for patients with a family history of ovarian cancer. Risk assessment is most relevant for women between ages 35-60.
Individuals with a family history of bowel cancer are assessed according to the British Society of Gastroenterology Guidelines for Bowel Cancer.
Who we see
We accept referrals for individuals from age 35 if they meet one or more of the below family history criteria. Guidance is most appropriate for those with no personal history of breast, ovary or bowel cancer themselves.
If the patient has had a cancer or tumour themselves and you have concerns, please contact the Cancer Genetics department through Electronic Referral System (ERS) for advice and guidance, or at cancergenetics@stgeorges.nhs.uk to see if a referral to Clinical Genetics may be appropriate.
Answering ‘yes’ to any of these questions does not guarantee an individual is eligible for additional cancer risk screening, but patients may be invited to complete the FHQS for a full family history assessment. Patients who answer ‘no’ or ‘I don’t know’ to all these questions should not be referred to our service.
Some referrals may be discharged or deferred with an explanatory letter. If there are further questions, please email cancerfamilyhistory@stgeorges.nhs.uk.
| Family History Screening Questions |
| Has someone from this list had breast cancer under the age of 50*?
Mother Sister Daughter Aunt Grandmother |
| Has someone from this list had bilateral breast cancer or cancer twice in the same breast more than 5 years apart?
Mother Sister Daughter Aunt Grandmother |
| Has someone from this list had male breast cancer?
Son Father Brother Grandfather |
| Has someone from this list had ovarian cancer?
Mother Sister Daughter Aunt Grandmother |
| Have two or more people on this list on the same side of the family had any of the following cancers: breast, ovarian, pancreatic, prostate
Parent Brother/Sister Child Aunt/Uncle Grandparent Niece/Nephew |
| Has someone on this list had bowel cancer under 50 or two close relatives on the same side of the family with bowel cancer at any age?
Parent Brother/Sister Child Aunt/Uncle Grandparent |
| Have two or more people on this list on the same side of the family had any of the following cancers: bowel, womb, stomach, pancreatic, ovarian
Parent Brother/Sister Child Aunt/Uncle Grandparent Niece/Nephew |
* NICE CG164 recommends referral when a single first degree relative (FDR) has breast cancer under age 40. However, internal data suggests that most women with an FDR under age 50 will fall within the moderate breast cancer risk category put forth by NICE. Our referral criteria have been updated accordingly.
Making a referral to the Virtual Family History Service
We encourage referrals to the Virtual Family History Service for any patient who meets one of the criteria above. However, some patients may be discharged back to their GP if they are too young to begin screening or have aged out of screening.
Breast screening for individuals at moderate risk is recommended annually from age 40-49. Individuals at high risk are recommended breast screening annually from 40-59.
Each patient will be triaged by a clinician and, if they are not invited to complete the FHQS and undergo a full assessment at this time, an explanatory letter will be sent to them and to their GP with guidance.
We ask that GPs refer via Electronic Referral System (ERS). Other providers can email referrals directly to: cancerfamilyhistory@stgeorges.nhs.uk. We also accept non-GP 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: cancerfamilyhistory@stgeorges.nhs.uk.