Why a Panel, and Why 108 Genes?
When people picture genetic cancer testing, they usually picture two genes: BRCA1 and BRCA2. But hereditary cancer risk is distributed across dozens of genes and more than a dozen cancer types — and a test that stops at BRCA misses most of the families it could help. The GeneCancer panel analyzes 108 genes selected for one reason: each has published evidence linking pathogenic variants to actionable, elevated cancer risk. As Lab Director, panel design is the decision I am asked about most — so here is exactly what those 108 genes measure, and what they can and cannot tell you.
How a 108-Gene Panel Is Designed
Panel design is an evidence-triage exercise. A gene earns its place when pathogenic variants in it (a) measurably raise risk for one or more cancers, and (b) change what a person should do — earlier screening, risk-reducing options, cascade testing for relatives. Genes with suggestive-but-unproven associations are deliberately excluded, because reporting non-actionable findings creates anxiety without benefit. The result is a panel anchored on the syndromes that guidelines like NCCN address directly:
| Gene / Group | Associated Cancers | Lifetime Risk Without Testing (Published) | What Changes With a Positive Result |
|---|---|---|---|
| BRCA1 | Breast, ovarian, prostate, pancreatic | Breast up to 72% · ovarian up to 44% | MRI + mammogram from 25, risk-reducing surgery options, cascade testing |
| BRCA2 | Breast, ovarian, prostate, pancreatic, melanoma | Prostate up to 27% by age 80 in men | Enhanced breast + prostate screening, PARP-inhibitor treatment relevance |
| Lynch syndrome (MLH1, MSH2, MSH6, PMS2, EPCAM) | Colorectal, endometrial, ovarian, stomach, urinary tract | Colorectal up to 80% · affects ~1 in 279 people | Colonoscopy every 1–2 years, aspirin strategies, risk-reducing surgery for women |
| TP53 (Li-Fraumeni) | Sarcomas, breast, brain, adrenocortical, leukemia | Very high lifetime risk, often childhood-onset | Whole-body MRI surveillance protocols, radiation avoidance where possible |
| PALB2, ATM, CHEK2 | Breast, pancreatic, ovarian, prostate, colorectal | Moderate-to-high, gene-specific | Earlier/enhanced breast imaging, pancreatic surveillance in select families |
What the Panel Actually Measures
The test reads the 108 genes from a cheek-swab DNA sample and classifies every variant found against current clinical evidence. Three numbers describe the panel's scope:
Genes analyzed — BRCA1/2, Lynch syndrome genes, TP53, PALB2, ATM, CHEK2, APC, MUTYH, and 100 more with actionable evidence.
Cancer types covered — breast, ovarian, colorectal, pancreatic, prostate, melanoma, stomach, thyroid, kidney, and more.
Analytical accuracy from our CLIA-certified, ISO 15189 laboratory — every report dual-reviewed before release.
The Result Nobody Explains: The VUS
A variant of uncertain significance (VUS) is a DNA change whose clinical effect is not yet established by published evidence. It is the most misunderstood result in genetics. Here is the essential framing: a VUS is not a positive result. Medical decisions — surgery, enhanced screening — should never be made on a VUS alone, and major guidelines are explicit about this. Variants get reclassified over time as evidence accumulates; most VUS results ultimately resolve to benign. This is why our membership includes quarterly reinterpretation: when the evidence moves, your report moves with it, and we tell you.
What Your Result Actually Means
| Result | What It Means | What It Does NOT Mean | Next Step |
|---|---|---|---|
| Positive (pathogenic variant found) | Published evidence links this variant to elevated risk for specific cancers | Not a cancer diagnosis — risk, not destiny | Genetic counseling (included), guideline-based screening plan, cascade testing for relatives |
| Negative (no pathogenic variant found) | No actionable variant detected in the 108 genes tested | Not zero risk — most cancer is not hereditary, and family history still matters | Follow standard population screening; revisit if family history changes |
| VUS (uncertain variant found) | A change was found whose significance is not yet established | Not a positive result — do not act on it medically | No change to care; quarterly reinterpretation watches for reclassification |
What This Means For You
If cancer runs in your family — especially breast, ovarian, colorectal, or pancreatic cancer, or any diagnosis before age 50 — a 108-gene panel tells you whether an inherited variant explains the pattern and what to do about it. GeneCancer runs from an at-home cheek swab with results in 5–7 days (48-hour priority available), genetic counseling included with every positive result, and NCCN-aligned next steps. $499 one-time, or included with the $89/month membership alongside all 11 tests. Learn more on the hereditary cancer screening hub, the GeneCancer page, or our Lynch syndrome guide.
FAQs
It analyzes 108 genes with published evidence for actionable hereditary cancer risk — BRCA1, BRCA2, the Lynch syndrome genes (MLH1, MSH2, MSH6, PMS2, EPCAM), TP53, PALB2, ATM, CHEK2, and 100 more — covering 15+ cancer types including breast, ovarian, colorectal, pancreatic, and prostate.
No. A variant of uncertain significance means the evidence is not yet sufficient to classify the change — it is not a positive result and should not drive medical decisions. Most VUS results are eventually reclassified as benign; Gene Matrix membership includes quarterly reinterpretation so reclassifications reach you automatically.
A negative result means no actionable variant was found in the genes tested — reassuring, but not zero risk. Most cancers are not hereditary, so standard age-based screening still applies, and a strong family history warrants discussion with your physician even after a negative panel.
GeneCancer is $499 one-time, or included with the $89/month membership ($59/mo billed annually, $712/yr) with all 11 tests. Results in 5–7 days (48-hour priority available) from a CLIA-certified, ISO 15189 lab, with genetic counseling included for positive results.
