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The Chompret criteria: when TP53 testing is offered | CION Cancer Clinics
The Chompret criteria are the checklist doctors use to decide who should be offered a test for an inherited TP53 fault, the cause of Li-Fraumeni syndrome. They look at which cancers you and your close relatives have had, and how young you were. This page explains the four routes in plain language, how a counsellor applies them, and what they cannot tell you. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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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 the Chompret criteria?
- Which families meet the criteria?
- How does a counsellor check your family against the criteria?
- The words you will hear, in plain language
- What points towards testing, and what usually does not
- What this page cannot tell you
- Four things families tell us, and what is actually true
- Common questions about the Chompret criteria
The short answer
What are the Chompret criteria?
The Chompret criteria are a checklist doctors use to decide who should be offered a test for an inherited TP53 fault. They look at which cancers a person has had, how young they were, and what cancers their close relatives had. Meeting them means testing is worth offering. It does not mean a fault will be found.
Where they came from
They were drawn up by a French group studying families with Li-Fraumeni syndrome, the condition an inherited TP53 fault causes. The list has been revised as more families were studied. The version most teams use today was published in 2015, and it is the one described on this page.
Why a checklist at all
A positive TP53 result changes a great deal. It brings lifelong scans, changes treatment choices and raises questions for every relative. So doctors want to test the people most likely to carry the fault. A checklist also avoids confusing results in people for whom testing would tell them little.
What the criteria are good at
They pick out most families with a TP53 fault while keeping the number of people tested manageable. They are wider than the older classic criteria, which needed a sarcoma and several young relatives with cancer and missed many carriers. Even so, no checklist catches every family, and doctors can still offer the test when the pattern looks worrying.
The criteria are a guide for your doctor. They are not a verdict on your family.The four routes
Which families meet the criteria?
Meeting any one of these four is enough. The core cancers mentioned are breast cancer before menopause, sarcoma, brain tumours and adrenal cortex cancer.
A family pattern
You had a core cancer before the age of 46, and a close relative had a core cancer before 56 or had several cancers. A close relative here means a parent, sibling or child, or a grandparent, aunt, uncle, niece or nephew.
If you had breast cancer, a relative's breast cancer does not count towards this route.Several cancers in one person
You have had more than one separate cancer, at least two of them core cancers, and the first appeared before the age of 46. Several breast cancers alone do not count.
A rare tumour, whatever the family history
Some tumours are so closely tied to TP53 that one is enough on its own, even when nobody else in the family has had cancer.
These are
- Adrenal cortex cancer
- Choroid plexus carcinoma, a rare brain tumour
- A particular anaplastic form of rhabdomyosarcoma
Very early breast cancer
Breast cancer diagnosed before the age of 31, with or without any family history. At that age TP53 is usually checked alongside BRCA1, BRCA2 and other breast cancer genes on one panel.
Not sure whether this applies to you?
Ask an oncologistIn the clinic
How does a counsellor check your family against the criteria?
Drawing the family tree
Three generations, on both sides. Who had cancer, which kind, and roughly how old they were when it was found.
Confirming the details
Old reports, discharge summaries and death records help. A "stomach problem" in a grandparent may turn out to be something else entirely.
Applying the criteria
The counsellor checks the four routes, along with other guidelines that cover a few extra situations the Chompret list leaves out.
Choosing who to test first
Usually the relative who has had cancer, because their result tells the rest of the family whether there is a fault to look for.
In the counselling room
The words you will hear, in plain language
- Proband
- The person the family assessment starts from. Usually the one who has had cancer.
- Core cancers
- The cancers most closely tied to TP53: breast cancer before menopause, sarcoma, brain tumours and adrenal cortex cancer.
- First-degree relative
- A parent, brother, sister or child. They share about half your genes.
- Second-degree relative
- A grandparent, grandchild, aunt, uncle, niece, nephew or half-sibling.
- Classic criteria
- The older, stricter checklist from the original Li-Fraumeni studies. It needs a sarcoma and several young relatives with cancer.
- Germline
- Present in every cell from birth and able to pass to children. The criteria are about germline TP53 faults only.
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Side by side
What points towards testing, and what usually does not
Points towards TP53 testing
Usually does not, on its own
Adrenal cortex cancer in a child
One relative with cancer in old age
Breast cancer at a very young age
Breast cancer after menopause with no pattern
Sarcoma plus a young relative with a core cancer
Common cancers scattered across distant relatives
Two different core cancers in one person
Two breast cancers in one person
A choroid plexus tumour at any age
A TP53 change found only inside a tumour
Being straight with you
What this page cannot tell you
It cannot tell you whether your family meets the criteria. Small details decide it, such as the exact type of a relative's cancer or whether a diagnosis was ever confirmed. A counsellor who has seen the records can answer that. Many families who meet the criteria test negative.
Missing the criteria is not an all-clear
Some carriers do not meet them. Families in India are often small, relatives may have died without a clear diagnosis, and records are lost. A fault can also appear for the first time in one person. If your history worries you, ask anyway.
An unexpected result from a wide panel
When TP53 turns up on a panel in someone who meets none of the criteria, the counsellor looks harder before acting. In older adults, or after chemotherapy, a TP53 change can build up in blood cells alone and is not inherited. A second sample, such as skin, may be tested to settle it.
Who this does not apply to
If you already have a positive TP53 result from a wider gene panel, the criteria no longer decide anything. What your specific variant means is a question for the counsellor who ordered the test. A TP53 change found only in a tumour belongs with the tumour testing pages.
Commonly believed
Four things families tell us, and what is actually true
"We meet the criteria, so we must have Li-Fraumeni."
Meeting them means testing is worth doing. Many families who meet them turn out to have no TP53 fault, and their cancers have another explanation.
"We don't meet them, so we can relax."
The criteria were built from well-recorded Western families. A small family, or one with missing records, can fall short and still carry a fault.
"Only the mother's side matters."
Both sides count equally. A father can carry and pass on a TP53 fault, and relatives on his side are part of the check.
"A child is too young for any of this."
Two of the four routes are mainly about children's tumours. A single rare tumour in a child can be enough to offer the test.
Questions we are asked
Common questions about the Chompret criteria
Who decides whether my family meets the criteria?
A genetic counsellor or clinical geneticist, usually with your oncologist. They go through the family history in detail and check each route. A checklist filled in at home is a useful start, but it cannot replace that conversation.
Are there other guidelines besides Chompret?
Yes. The older classic criteria are stricter, and international guidelines such as NCCN add a few situations of their own. Your counsellor looks at all of them together rather than relying on one list.
What if a relative's cancer type is unknown?
Tell the counsellor what you do know, even if it is vague. Hospital records can sometimes be traced. When they cannot, the counsellor weighs the uncertainty and may still suggest testing if the rest of the pattern fits.
Why is breast cancer in a man not on the list?
Breast cancer in a man points more strongly to other genes, especially BRCA2. It still prompts a genetic referral, and a wider panel will usually include TP53 as well.
Can I be tested without meeting the criteria?
Sometimes. TP53 is included in many gene panels used for breast and other cancers. That can lead to an unexpected TP53 result, which then needs careful checking by a counsellor before anyone acts on it.
Should my children be tested if I meet the criteria?
Not yet. The first step is to test you, or the relative who had cancer. Only if a fault is found does testing children come up, and that is discussed carefully with the family.
Does counselling happen in Telugu?
Ask for it when you book. Family histories are easier to give in the language your family actually speaks, and a relative can join the appointment to help remember names and ages.
Where do I start?
Write down every relative on both sides who had cancer, what kind, and roughly at what age. Take the list to your oncologist or a genetic counsellor. The CION helpline can point you to the right clinic.
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)
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Sources
- GeneReviews (NCBI) — Li-Fraumeni Syndrome
- MedlinePlus Genetics — Li-Fraumeni syndrome
- NCCN — Genetic/Familial High-Risk Assessment: Breast, Ovarian, Pancreatic, and Prostate
- National Cancer Institute — Genetics of Breast and Gynecologic Cancers (PDQ)
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
TP53 mutation: which cancers and what riskWhat the core cancers are, and when they appearA de novo TP53 result with no family historyWhen a fault turns up in a family that met no criteriaTesting the family for TP53Who is tested next once a fault is foundTP53 testing cost in HyderabadWhat the test costs once it is offered
Talk to us
Not sure whether your family meets the criteria?
Tell us who in your family had cancer and at what age. A counsellor will tell you honestly whether TP53 testing is worth doing. One helpline serves every CION centre.