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No Mutation Detected or Favor Polymorphism This letter is an example of what you can write and send to relatives with a copy of your genetic testing results. Dear [ ]: I recently had genetic testing to help me understand my risk of developing cancer. I was tested for inherited changes (or mutations) in the [APC/MLHI/MSH2/MSH6/PMS2] gene. Mutations in these genes are associated with a high risk of colorectal cancer and other kinds of cancer. My test did not find a mutation. This test result reduces the likelihood of a hereditary cancer syndrome but does not eliminate the possibility. There are some uncommon mutations in this gene that this test will not detect. There may be other genes besides the ones for which I was tested which, in rare cases, cause this syndrome. It is possible that someone in our family may have [APC/MLHI/MSH2/MSH6/PMS2] mutation. I am writing to all of the relatives who may be at risk to have a mutation because of the history of cancer in our family. You may want to talk to your doctor about whether genetic testing makes sense for you. I have included a copy of my test result with this letter which will be helpful when you are speaking with your doctor. To find a genetic counselor or medical geneticist who can also help you understand these test results, visit www.nsgc.org (National Society of Genetic Counselors) or www.acmg.net (American College of Medical Genetics). I hope you find this information helpful. Please let me know if you have any questions. Sincerely, [ ] Positive for a Deleterious Mutation This letter is an example of what you can write and send to relatives with a copy of your genetic test results. Dear [ ]: I recently had genetic testing to help me understand my risk of developing cancer. I was tested for inherited changes (or mutations) in the [APC/MLHI/MSH2/MSH6/PMS2] gene. My test identified a mutation that runs in our family (relatives related by blood). This test result means that I have [Lynch syndrome/Familial Adenomatous Polyposis syndrome/other]. This syndrome significantly increases my risk of colorectal cancer and other kinds of cancer. Fortunately, there are medical options to reduce my risks, which is why knowing about this mutation will be very helpful. It is possible that someone in our family besides me may have a [APC/MLHI/MSH2/MSH6/PMS2] mutation. I am writing to all of the relatives who may be at risk to also have this mutation. You may want to talk to your doctor about whether genetic testing makes sense for you. I have included a copy of my test result with this letter which will be helpful when you are speaking with your doctor. To find a genetic counselor or medical geneticist who can also help you understand these test results, visit www.nsgc.org (National Society of Genetic Counselors) or www.acmg.net (American College of Medical Genetics). I hope you find this information helpful. Please let me know if you have any questions. Sincerely, [ ] Single Site – No Mutation Detected This letter is an example of what you can write and send to relatives with a copy of your genetic test results. Dear [ ]: I recently had genetic testing to help me understand my risk of developing cancer. I was tested for an inherited change (a [APC/MLHI/MSH2/MSH6/PMS2] mutation) that was previously identified in our family. Mutations in this gene are associated with a high risk of colorectal cancer and other kinds of cancer. My test did not find the mutation that runs in our family. This means that I do not have the significantly increased risks of cancer associated with this mutation. However, my result does not eliminate the general population risks for colorectal and other cancers, so routine cancer screening is still important for me. It is possible that other people in our family have this mutation. I am writing to all of the relatives who may be at risk to have this mutation because of the history of cancer in our family. You may want to talk to your doctor about whether genetic testing makes sense for you. I have included a copy of my test result with this letter which will be helpful when you are speaking with your doctor. To find a genetic counselor or medical geneticist who can also help you understand these test results, visit www.nsgc.org (National Society of Genetic Counselors) or www.acmg.net (American College of Medical Genetics). I hope you find this information helpful. Please let me know if you have any questions. Sincerely, [ ] Recommendation that a relative undergo tumor testing This letter is an example of what you can write and send to relatives if your doctor recommends that a relative undergo tumor testing for hereditary colorectal cancer Dear [ ]: I recently met with my healthcare provider to talk about my risk of developing cancer. Based on this risk assessment, I have learned that our family is at increased risk of having a hereditary cancer syndrome call Lynch syndrome. Genetic testing for colorectal cancer is most informative when it is done on someone in the family who personally has had cancer. Because you have had colorectal cancer, you may want to talk to your doctor about whether genetic testing makes sense for you. The genetic testing that is recommended is called [microsatellite instability (MSI) / immunohistochemistry (IHC)] testing, and it would be done on the cancer tumor that was removed during your surgery. Your doctor or a genetic counselor can help contact the hospital where your surgery was done to order the genetic testing. To find a genetic counselor or medical geneticist who can also help you understand these test results, visit www.nsgc.org (National Society of Genetic Counselors) or www.acmg.net (American College of Medical Genetics). I hope you find this information helpful. Please let me know if you have any questions. Sincerely, [ ]