TESTING GUIDELINES

IDENTIFYING PATIENTS AT RISK FOR HEREDITARY MELANOMA
Obtaining a detailed personal/family history is the first step in identifying individuals at increased risk for hereditary melanoma. The American Society of Clinical Oncology (ASCO) issued guidelines for cancer susceptibility testing, which stated testing should only be offered when:

	The individual has personal or family history features suggestive of a genetic cancer susceptibility condition
	The test can be adequately interpreted
	The results will influence the medical management of the patient or family

The following features warrant consideration for p16 genetic testing.

	Multiple diagnoses of primary melanoma in one individual
	Two or more family members with melanoma
	Melanoma and pancreatic cancer in one individual and/or the family
	Melanoma and a personal/family history of melanoma and multiple atypical moles
	Relatives of a p16 mutation carrier

There is a proportional relationship between the presence of a p16 mutation and the number of affected family members with melanoma. Hereditary melanoma and genetic testing may be appropriate for families with at least two or more affected family members, one of whom is a first degree relative. Early age of onset of cancer, multiple primary tumors, and family/personal history of pancreatic cancer may further suggest p16 gene involvement.

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