Abstract
Identifying and surveying those individuals at risk for familial cancer are extremely important for the prevention and early detection in order to avoid early death from cancer. In this article, the background, domain, components, and goal of cancer genetic counseling for familial cancer as a part of the process of cancer risk counseling are described, drawing upon US and UK literatures and our own clinical experience. The differences between this type of counseling and that of genetic counseling for reproductive issues are also discussed. A decision tree for the process of cancer risk counseling was developed that recognizes the interaction of hereditary and environmental factors. In the tree, DNA testing was included as an optional strategy for confirming susceptibility to the development of cancer. For each point of decision in the tree, references are provided where necessary and intervention strategies are included. The strategies described in the tree reveal the characteristics of cancer risk counseling : educational intervention is essential for the prevention of cancer. Counseling activities and training programs of genetic counselor for cancer risk counseling in US and UK are introduced, and the necessity for training of counselor in Japan is emphasized.
