WHAT IS THE CANCER GENETICS SERVICE FOR WALES?
The Cancer Genetics Service for Wales (CGSW) is part of the All Wales Medical Genetics Service (AWMGS). It was established in 1996 to respond to the increasing demand for information and clinical care for people at risk of cancer because of a family history. CGSW is for anyone in Wales who has had a number of family members with cancer, and who is worried that they themselves may be at increased risk of inherited cancer.
Only 5-10% of cancers of the breast, ovary and colon are due to an inherited predisposition. Individuals with a significant family history can be referred to CGSW. The remit of CGSW is to assess the risk of cancer based on the reported family history, to work with the relevant specialist clinicians and recommend further screening strategies where appropriate. 
HOW DO I KNOW IF I HAVE A SIGNIFICANT FAMILY HISTORY OF CANCER?
You may have a significant family history of cancer if you can answer ‘yes’ to either of the following questions:
1. Are there two or more close relatives on the same side of your family with cancer?
2. Has any relative been under 45 when diagnosed with cancer?
If you have answered ‘yes’ to either of these questions, it may be appropriate for your risk to be assessed more fully. Discuss with your GP or other healthcare professional, who can decide if you should be referred to CGSW.
WHAT HAPPENS TO THE REFERRAL?
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A family history questionnaire is sent to you to identify family history and baseline information. (The referral is only taken further if your questionnaire is returned.)
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Where necessary, the family history is clarified and confirmed.
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A risk assessment is undertaken to categorise you as ‘high’, ‘moderate’ or ‘average’ risk.
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The patient, referring doctor and GP are informed of the risk category.
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All high-risk and some moderate-risk patients are offered an appointment in the Cancer Genetics Clinic.
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All patients are given contact details for the Cancer Genetics Service for Wales and invited to recontact the service in the event of a change in family history.
AVERAGE RISK
This group is reassured that, on the information given, their risk is not significantly raised above that of the general population, so extra surveillance is not recommended. They should continue standard health awareness and screening as for the general population.
MODERATE RISK
CGSW coordinates ongoing management between primary care and appropriate specialist clinicians (e.g. local breast or colorectal surgeons) or screening organisations (e.g. Breast Test Wales). Patients may be referred directly by CGSW or an appropriate referral route for the GP will be suggested. In some cases laboratory investigations may be recommended to help clarify a patient's risk status.
HIGH RISK
In addition to suggesting the involvement of other specialist clinicians and recommending appropriate surveillance, this group will be seen in the Cancer Genetics Clinic and genetic testing may be offered in some families.
Information about the Cancer Genetics Service for Wales (CGSW) can be found within the CGSW Information leaflet.
