J.P. is a 45-year-old Caucasian female who

J.P. is a 45-year-old Caucasian female who has recently been diagnosed with right-sided colon cancer. She has asked about the possibility of a cancer predisposition in her family. J.P. had a personal history of a colon polyp at age 43, type unknown. Further medical history is unremarkable. Reproductive history includes: menarche at age 12, G2P2AO, first live birth at age 21. J.P. breast-fed both her daughters for a total of 6 months. No oral contraceptive or hormone replacement use. J.P. continues to have regular menstrual periods. J.P. has two daughters ages 22 and 25, both cancer free and healthy. J.P. has a sister age 48 that was diagnosed with endometrial cancer at age 40 and underwent a total abdominal hysterectomy and bilateral salphingo-oophorectomy and currently has no evidence of disease. This sister has two children, a girl age 20 and a boy 23. Both children are cancer free, but the boy has recently developed rectal bleeding and is seeing his doctor this week. J.P. also has a brother who was diagnosed with colon cancer at age 39 and died of metastatic colon cancer at age 42 and never had any children. J.P.’s mother was diagnosed with ovarian cancer at age 50 and died at age 51. J.P.’s mother had two brothers and one sister. J.P.’s mother’s sister was diagnosed with colon cancer at age 41 and is alive today at age 63 and has one son who is cancer free at age 39 and one daughter age 42 who was diagnosed with rectal cancer at age 40. One of J.P.’s maternal uncles is alive and well at 67, and has a daughter and a son in their early 40’s. J.P’s other maternal uncle is alive and well at 69 and never had children. J.P.’s maternal grandmother died at 75 of heart disease. There is no information on the maternal grandmother’s sibling’s medical history. The maternal grandmother was of German, Protestant background. J.P.’s maternal grandfather was of Irish, Catholic background had colon cancer in his late 30’s and died shortly after diagnosis. J.P.’s father is Caucasian with no history of cancer at age 70 and has hypertension but otherwise is in good health. J.P.’s father was adopted and nothing is known about his family or their ethnic background. J.P.’s spouse is an only child 50 years old, Caucasian with no health problems and both his parents are alive and well in their 70’s and are Irish/Catholic. What genetic tests if available would you advise? Thank you in advance!!

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