Clinical genetics · London
The right hereditary cancer panel, interpreted by a consultant clinical geneticist.
Beyond BRCA1 and BRCA2. Lynch, FAP, Li-Fraumeni, Cowden, MEN, VHL, PALB2 and the rest of the monogenic cancer syndromes, tested on a single panel and explained in plain English.
Why patients choose us
- 01
Clinical geneticist led
Every panel is ordered and interpreted by a consultant clinical geneticist, not a lab technician.
- 02
Counselling before and after
Pre-test and post-test genetic counselling are booked as standard, including cascade testing for family.
- 03
A vetted London panel
Great Ormond Street, King's, Guy's, Royal Marsden and HCA cancer genetics services, matched to your case.
Indicative pricing
Honest ranges, counselling included.
Panel cost varies with gene count and laboratory. Pre and post-test counselling with a consultant clinical geneticist is billed separately and is essential.
| Service | Indicative range | Appointment | Turnaround |
|---|---|---|---|
| Pre-test genetic counselling (60 min) | £350–£550 | 45–60 min | Same visit |
| Single-gene targeted test (known family variant) | £280–£550 | 15 min draw | 2–3 weeks |
| Focused panel (15–25 genes) | £550–£1,400 | 15 min draw | 3–4 weeks |
| Comprehensive panel (60–80+ genes) | £850–£2,200 | 15 min draw | 4–6 weeks |
| Post-test counselling and written plan | £350–£550 | 45–60 min | Same visit |
| Cascade testing (per relative) | £150–£350 | 15 min draw | 2–3 weeks |
| NHS Genomic Medicine Service (if eligible) | Free | 15 min draw | 6–12 weeks |
Laboratories in routine use include Myriad myRisk (35 genes), Ambry CancerNext (67 genes), Invitae Multi-Cancer (81 genes) and Color (30 genes). The clinical geneticist selects the panel that fits your case.
Who should test
When a panel earns its place.
Testing is most useful where a personal or family history points to a monogenic cause. These are the standard indications.
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Young cancer onset
A personal diagnosis under 50, or a first-degree relative diagnosed under 50.
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Multiple primaries
Two or more separate primary cancers in the same person, or three related cancers in one family lineage.
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Rare tumour types
Medullary thyroid carcinoma, phaeochromocytoma, sarcoma, desmoid, adrenocortical or renal cancer under 50.
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Polyposis phenotype
Ten or more colonic polyps at colonoscopy, or a personal history of hamartomatous polyps.
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Mismatch repair deficiency
A tumour reported as MSI-high or with loss of MLH1, MSH2, MSH6 or PMS2 on IHC.
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Ashkenazi Jewish ancestry
Expanded panels are appropriate given founder mutations beyond BRCA1 and BRCA2.
What the panel covers
The syndromes beyond BRCA.
A comprehensive panel typically includes the following monogenic cancer predisposition syndromes.
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Lynch syndrome
MLH1, MSH2, MSH6, PMS2, EPCAM
Colorectal, endometrial, ovarian, gastric, urothelial, pancreatic and skin sebaceous cancers.
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Familial adenomatous polyposis (FAP)
APC
Hundreds of colonic polyps from adolescence, duodenal, desmoid and thyroid risk.
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MUTYH-associated polyposis
MUTYH (biallelic)
Recessive polyposis phenotype with a high lifetime colorectal cancer risk.
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Peutz-Jeghers syndrome
STK11
GI hamartomas, mucocutaneous pigmentation, breast, gastric, pancreatic and gynae risk.
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Juvenile polyposis / HHT
SMAD4, BMPR1A
GI polyposis with an overlap with hereditary haemorrhagic telangiectasia.
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Cowden syndrome (PHTS)
PTEN
Breast, thyroid, endometrial, colon and kidney cancers with characteristic skin features.
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Li-Fraumeni syndrome
TP53
Early onset sarcoma, breast, brain, adrenocortical carcinoma and leukaemia.
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Hereditary diffuse gastric cancer
CDH1
Diffuse-type gastric cancer and lobular breast cancer, often young onset.
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Von Hippel-Lindau
VHL
Renal cell carcinoma, phaeochromocytoma, haemangioblastoma and pancreatic tumours.
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MEN1
MEN1
Parathyroid, pituitary and pancreatic islet cell tumours.
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MEN2A and MEN2B
RET
Medullary thyroid carcinoma with phaeochromocytoma; prophylactic thyroidectomy in infancy for high-risk codons.
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Neurofibromatosis
NF1, NF2
Nerve sheath tumours, cutaneous features and elevated malignancy risk.
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Hereditary paraganglioma-phaeochromocytoma
SDHB, SDHD, SDHC, SDHA, MAX, TMEM127, FH
Head, neck, thoracic and abdominal paragangliomas.
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Melanoma predisposition
CDKN2A, BAP1, POT1
Familial cutaneous melanoma; BAP1 also raises mesothelioma and uveal melanoma risk.
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Retinoblastoma
RB1
Childhood retinal tumour with second-primary sarcoma risk in survivors.
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Wilms tumour predisposition
WT1
Paediatric renal tumour, often part of a wider syndrome.
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Moderate-risk breast panel
PALB2, ATM, CHEK2, RAD51C, RAD51D, BARD1
Moderate breast and ovarian risk beyond BRCA1 and BRCA2.
The journey
From enquiry to a written plan.
Counselling led throughout. Typically four to six weeks end to end.
- 01
Before
Confidential enquiry
A short form about your personal and family cancer history. We flag any red-flag features straight away.
- 02
Before
Pedigree and eligibility review
A three-generation family pedigree is built. If you are NHS-eligible via the Genomic Medicine Service, we tell you.
- 03
Before
Pre-test counselling
45 to 60 minutes with a consultant clinical geneticist covering scope, VUS risk, insurance and family implications.
- 04
Sample day
Sample taken
A saliva kit or a single blood draw at a Harley Street clinic. No fasting, no preparation.
- 05
Sample day
Laboratory analysis
Next-generation sequencing of 25 to 80+ genes at an accredited lab (Myriad, Ambry, Invitae or NHS GLH).
- 06
After
Post-test counselling
Results reviewed in person or by video. Pathogenic, likely pathogenic and VUS variants explained with a written plan.
- 07
After
Surveillance and cascade
Referral into enhanced surveillance pathways and coordinated cascade testing for eligible relatives.
Before you consent
Genetic testing is safe. The result is not always simple.
These are the areas we always cover at pre-test counselling.
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Variants of uncertain significance
Roughly one in ten panels return a VUS. It is not actionable and may be reclassified over time. We explain this before you consent.
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Insurance implications
Under the 2018 ABI Code, UK insurers cannot ask for predictive genetic test results, except Huntington's disease for life cover above £500,000.
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Impact on relatives
A positive result changes the risk profile of parents, siblings and children. Cascade testing is offered and coordinated.
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Psychological support
A clinical psychologist familiar with cancer genetics is available before and after results, particularly for Li-Fraumeni and paediatric syndromes.
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Reproductive options
Pre-implantation genetic testing for monogenic disorders (PGT-M) is available privately once a pathogenic variant is confirmed.
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Data and consent
Samples and data handling follow UK GDPR. Written consent covers testing, storage, incidental findings and family sharing.
Your report
A four-part report, not a spreadsheet.
Every panel comes back with a laboratory report and a clinical letter. The clinical letter is what you and your GP work from.
- 01 Variants
What was found
Pathogenic, likely pathogenic and variants of uncertain significance are listed against ACMG classification.
- 02 Genes tested
What was analysed
The full gene list, coverage metrics and any regions with limited analytical sensitivity.
- 03 Interpretation
What it means
The clinical geneticist's interpretation for you and your family, in plain English.
- 04 Plan
What happens next
Surveillance schedule, risk-reducing surgery options, chemoprevention and cascade testing.
Frequently asked
Six questions we hear before every panel.
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How is this different from a BRCA1 or BRCA2 test?
BRCA1 and BRCA2 cover hereditary breast and ovarian cancer syndrome only. A non-BRCA panel adds the other monogenic cancer syndromes: Lynch, FAP, Li-Fraumeni, Cowden, hereditary diffuse gastric cancer, VHL, MEN, paraganglioma and moderate-risk breast genes such as PALB2, ATM and CHEK2.
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Which panel size do I actually need?
The right panel depends on your family history and any tumour features. A focused 15 to 25 gene panel is usually enough when the clinical picture points one way; a comprehensive 60 to 80 gene panel is preferable where the family history is mixed or the phenotype is unclear. The consultant clinical geneticist decides at pre-test counselling.
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Am I NHS-eligible through the Genomic Medicine Service?
Possibly. NHS GMS uses NICE-approved criteria based on age at diagnosis, family history score and tumour features. If you qualify, the panel is free but reports typically take 6 to 12 weeks. Private access is faster and open to anyone.
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What happens if a pathogenic variant is found?
You move into an enhanced surveillance pathway: annual breast MRI, colonoscopy, upper GI endoscopy, dermatology review or renal imaging as relevant. Risk-reducing surgery, chemoprevention and reproductive options are discussed. Cascade testing is offered to eligible relatives.
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Will this affect my insurance?
Under the ABI Code on Genetic Testing and Insurance, UK insurers cannot request or use predictive genetic test results. The only exception is Huntington's disease for life cover above £500,000. Hereditary cancer panels are not disclosable.
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How long do results take?
Private turnaround is typically three to six weeks from sample to reported result. NHS GMS turnaround is six to twelve weeks. Cascade testing for a known family variant is faster, usually two to three weeks.
Talk to a clinical geneticist
Tell us your family history. We will tell you which panel makes sense.
One working day to a written recommendation, including whether you are eligible free of charge through the NHS Genomic Medicine Service.