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CION Cancer Clinics
Genetic testing criteria, explained without the jargon | CION Cancer Clinics
Testing criteria are published checklists that professional bodies put together, setting out which family histories are worth a genetic test. They are not a test themselves, and meeting them is not a prediction of the result. This page explains what they check, how they get applied, and what happens if your family falls just short. At CION Cancer Clinics in Hyderabad, our oncologists review your family history with you and guide you to the right genetic counselling and testing.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- What are "testing criteria" actually?
- Four things every set of criteria looks at
- How criteria actually get applied to your family
- Words used when criteria are discussed
- Meeting the criteria compared with not meeting them
- Beliefs about testing criteria, checked
- What this page cannot tell you
- Common questions about testing criteria
The short answer
What are "testing criteria" actually?
Testing criteria are published checklists that professional bodies put together, setting out which family histories and cancer diagnoses are worth referring for genetic testing. They are not a test in themselves. They are the yardstick a counsellor holds your family history up against.
Where these checklists come from
Groups of oncologists, geneticists and counsellors review the published evidence and agree on combinations of age, relative count and cancer type that reliably predict an inherited fault. These groups revisit and update their guidance as new evidence comes in.
Why criteria exist at all
Testing every single person would find very few faults for a great deal of unnecessary worry and expense. Criteria exist so that testing, and the counselling that goes with it, reaches the people most likely to actually carry something.
Criteria are a starting point, not a verdict
Meeting the criteria opens the door to a proper conversation and, in most cases, a test. It says nothing yet about what that test will find. Falling short of the criteria closes no door permanently either, since a counsellor can still weigh something unusual about your family that a checklist alone would not catch.
Meeting criteria is a recommendation to test, not a prediction of the result.What gets checked
Four things every set of criteria looks at
Different guidelines phrase it differently, but they are almost always weighing the same handful of factors.
Age at diagnosis
A cancer diagnosed well before the age it typically appears is weighted heavily in almost every set of published criteria.
Pattern of relatives
How many close relatives are affected, how they are related to you, and which side of the family they sit on.
Specific cancer types and combinations
Some cancers, or specific combinations of cancers in one family, are known to travel together under a single inherited fault.
Known ancestry or community patterns
A small number of communities carry a specific fault more often because of shared ancestry, which some criteria account for separately.
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How criteria actually get applied to your family
Your family tree is drawn out
A counsellor records relatives, relationships, cancer types and ages as completely as you can recall them.
It is checked against the relevant guideline
Different cancer types have their own criteria, so the counsellor checks the one that fits your family's pattern.
Borderline cases are discussed further
Some families sit right on the edge of the criteria. These are often reviewed with a wider team before a decision is made.
Clinical judgement can still apply
A counsellor can recommend testing even when the criteria are not fully met, if something about the family looks unusual.
You are told the reasoning, either way
Whether testing is offered or not, the counsellor explains which factors decided it, so the decision does not feel arbitrary.
In plain language
Words used when criteria are discussed
- Guideline
- A published document from a professional body setting out recommended practice, including who should be offered testing.
- Meeting criteria
- Shorthand for a family history matching a guideline closely enough that testing is recommended rather than optional.
- Borderline case
- A family history that sits close to, but not clearly inside or outside, a set of published criteria.
- Clinical judgement
- A counsellor's decision to recommend testing based on the whole picture, even where the written criteria alone would not require it.
- Multigene panel
- A single test that checks several genes at once, often used when a family history fits more than one possible syndrome.
- Pre-test probability
- An estimate of how likely a fault is to be found, based on the family history, before the test is actually run.
- Variant of uncertain significance
- A spelling difference the laboratory found but cannot yet classify as harmful or harmless. It is not treated as a positive result while it remains unclassified.
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Side by side
Meeting the criteria compared with not meeting them
Meets the criteria
Does not meet the criteria
Testing is recommended as part of care
Testing is not routinely recommended
Pre-test counselling is arranged first
Family history alone guides screening instead
A fault is more likely to be found if present
A fault is less likely, though not impossible
Support for the cost may be discussed with the clinic
Testing outside the criteria is usually self-funded
Relatives can be offered the same specific test
Nothing specific exists yet to test relatives for
Decision is usually straightforward to explain
Decision may need a wider team discussion
What people assume
Beliefs about testing criteria, checked
"The criteria are the same everywhere in the world."
Different professional bodies publish their own versions, and they do not always agree exactly. A counsellor working in India applies the guidance most relevant here.
"If I don't meet the criteria, I cannot be tested at all."
You can usually still choose to be tested after counselling, even outside strict criteria, though it is then usually arranged and paid for privately rather than as a routine recommendation.
"Meeting the criteria means the test will be positive."
Meeting criteria means testing is worthwhile, not that it will find anything. Most people who meet the criteria and are tested still receive a negative result.
"The criteria never change once they are published."
They are reviewed and updated as evidence grows. A family told they did not qualify some years ago might be assessed differently against the current version, which is one reason it is worth asking again after a long gap rather than assuming the earlier answer still stands.
Being straight with you
What this page cannot tell you
It cannot tell you whether your family meets the criteria for any particular cancer. That takes a full family tree checked against the specific guideline that applies, which only a counsellor can do properly.
It cannot tell you what a scheme will cover
Aarogyasri, Ayushman Bharat and private insurance each treat genetic testing differently, and coverage changes. Ask the clinic directly what is covered before assuming either way, and be wary of any offer that sounds like financing rather than a straightforward quoted cost.
Who this does not apply to
If your family history has no pattern at all, chasing testing against a counsellor's advice is unlikely to help you. A negative recommendation is still useful information, not a door closed on you unfairly.
Not sure which criteria apply to your situation? Call the helpline and describe your family history plainly.Questions we are asked
Common questions about testing criteria
Who actually decides these criteria?
Professional bodies of oncologists, geneticists and counsellors, working from published research, put them together and update them over time as more evidence becomes available.
Can a counsellor recommend testing even if I don't meet the criteria?
Yes. Criteria are a guide, not a rigid rule. A counsellor can still recommend testing based on something unusual about your family that the checklist does not fully capture.
Do the criteria differ between cancer types?
Yes, considerably. Breast and ovarian cancer, colorectal cancer and prostate cancer each have their own published criteria, reflecting how differently inherited faults behave in each.
What happens if my family is a borderline case?
It is often discussed with a wider team before a decision is made. You will be told plainly which way the discussion landed and why, rather than left to guess.
Can I still get tested privately if I don't qualify?
Often yes, after proper counselling, though it is then usually arranged and funded privately rather than as a routine recommendation. Ask the clinic what this would involve.
Do the criteria account for Indian family patterns?
Many international guidelines are used with local clinical judgement layered on top, since community-specific patterns and marriage within the extended family are considered by an experienced counsellor.
How often are the criteria updated?
Major guideline bodies review their guidance on a regular cycle and issue updates as evidence accumulates, so a past assessment is not necessarily the final word.
Who checks whether my family meets the criteria?
A genetic counsellor, working from your family tree. Call the CION helpline if you are not sure how to start that conversation.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- NCCN — Genetic/Familial High-Risk Assessment Guidelines
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- ESMO — Clinical Practice Guidelines: Hereditary Cancer Syndromes
- American College of Medical Genetics and Genomics (ACMG) — Practice Resources
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Should you have genetic testing for cancer?What the criteria are ultimately decidingRed flags in a family historyThe patterns criteria are built to catchRisk assessment models: Tyrer-Cuzick, BOADICEA and ManchesterWhen criteria are turned into a calculated riskDo you meet the criteria? A self-checkA practical way to check your own family against this
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Not sure if your family meets the testing criteria?
Describe your family's history to us and we will tell you honestly where it stands against the published guidelines. One helpline serves every CION centre.