Promoting National Consistency in Hereditary Cancer Risk Assessment: The Importance of the ABS–UKCGG–CanGene–CanVar CanRisk Consensus
The publication of the ABS–UKCGG–CanGene–CanVar consensus on the use of CanRisk in clinical practice in the British Journal of Cancer on 4 June 2024 marked an important milestone in the delivery of hereditary cancer risk assessment across the UK. Developed through collaboration between the Association of Breast Surgery (ABS), the UK Cancer Genetics Group (UKCGG), CanGene and CanVar, the consensus provides practical guidance to support the consistent implementation of the CanRisk tool within clinical practice.
Vicki Kiesel, who participated in the national consensus meeting, views the publication as an important step towards achieving greater national consistency in hereditary cancer risk assessment. Bringing together experts from breast surgery, clinical genetics, oncology, laboratory science and genetic counselling enabled the development of recommendations that reflect multidisciplinary expertise and support equitable patient care across healthcare settings.
CanRisk has significantly advanced personalised cancer risk assessment by combining family history, genetic testing results, polygenic risk scores, lifestyle factors and other validated risk predictors into a single evidence-based platform. As the use of genomic medicine expands beyond specialist genetics services into mainstream breast and oncology practice, nationally agreed guidance has become increasingly important to ensure that patients receive consistent, high-quality assessments regardless of where they access care.
The consensus statement provides clinicians with practical recommendations on the appropriate use of CanRisk, including patient selection, interpretation of risk estimates, training requirements and the integration of results into clinical decision-making. Importantly, it reinforces that CanRisk is designed to support—not replace—clinical judgement, ensuring that individual patient circumstances remain central to risk assessment and management.
From Ms Kiesel’s perspective, one of the most significant achievements of the consensus is its potential to improve clinical practice through standardisation. Nationally agreed recommendations help reduce unwarranted variation in care, support confident decision-making by healthcare professionals and promote equitable access to evidence-based risk assessment throughout the NHS.
The consensus also recognises the rapidly evolving nature of genomic medicine. As new evidence emerges regarding susceptibility genes, polygenic risk scores and personalised prevention strategies, the collaborative framework established by the consensus provides a robust foundation for future updates to clinical guidance.
Ultimately, the greatest impact of the consensus will be on patient care. More consistent and accurate risk assessment supports informed decision-making regarding surveillance, preventive interventions and genetic testing, enabling increasingly personalised management while ensuring that NHS resources are used effectively.
For Ms Kiesel, the publication exemplifies the value of multidisciplinary collaboration in translating scientific advances into routine clinical practice. By establishing national recommendations for the use of CanRisk, the consensus supports healthcare professionals across the UK in delivering more consistent, evidence-based hereditary cancer risk assessment and represents an important contribution to improving clinical practice for individuals and families at increased risk of inherited cancer.