The Cancer Risk Evaluation Program (CREP) at the Cancer Institute of Doylestown Hospital provides information, evaluation and genetic counseling to assess personal risk for breast, ovarian or gastrointestinal cancer at no cost to you. CREP is a collaborative program established in partnership with Penn Medicine’s Abramson Cancer Center, designated by the National Cancer Institute (NCI) as a Comprehensive Cancer Center.
CREP offers support, guidance and answers to individuals concerned about their hereditary risk for cancer. By participating in CREP, patients may gain an advantage for early detection, participate in research or clinical trials, or learn prevention strategies for at-risk family members. A licensed, board-certified genetic counselor and CREP physician guide patients through every step of the process.
Risk Evaluation and Genetic Counseling Services
CREP patients can expect two visits with our team. Prior to your initial appointment, you will receive family history and personal health history questionnaires to complete so we can get important information about you and arrange appointments tailored to your personal needs.
The CREP team at the Cancer Institute of Doylestown Hospital provides the full range of risk evaluation and genetic counseling services. We work with participants to
- Discuss your personal concerns
- Review your family history, medical history and lifestyle risk factors
- Help you understand the risk factors involved, such as harmful mutations of the BRCA gene
- Discuss genetic testing and assist in your decision to pursue this option
- Evaluate your eligibility to participate in research studies
- Outline a plan for continued monitoring to protect your health
- Provide information for those individuals who have been diagnosed with cancer and want to know about the role of genetics in their diagnosis
- Provide a written summary of your risk level
What to Expect at Your Risk Assessment
Typically, patients undergoing cancer risk assessment attend two appointments which include consultations with both a genetic counselor and a CREP physician.
Your First Appointment with a Genetic Counselor
At your first appointment, you will meet with our board-certified genetic counselor to review your personal information and your family tree. You will learn about cancer risk factors, including how genes and family history can affect your level of risk. For patients concerned about their risk for breast and ovarian cancer, this will include a discussion about the BRCA gene and how BRCA testing can identify harmful genetic mutations.
After your first appointment, we will help you obtain any additional information needed such as radiology films, pathology slides or family medical records. Our CREP team reviews your information, assesses your risk, develops recommendations for follow-up care and determines your eligibility for participation in research studies. Our genetic counselor will contact you for a second appointment after the team completes the analysis and makes recommendations.
Your Second Appointment
During your second appointment, you will meet with a CREP physician and genetic counselor. At this visit, our physician will conduct a physical examination related to your personal situation. You will also learn the results of your cancer risk assessment. We will discuss a plan to carefully monitor your health based on your level of risk. This may include a schedule of periodic tests, physical exams or other specialized testing. You may be referred to other specialists, as needed, based on your situation. There will be plenty of time for questions.
If you decide on genetic testing, or agree to participate in a research study, a blood sample may be drawn at this visit.
Genetic Testing for Cancer
Genetic testing is offered to people with personal or strong family histories of breast, ovarian or gastrointestinal cancer to help determine if they are at high risk of having a genetic mutation, such as a harmful mutation of the BRCA gene. Our program provides education and counseling about the benefits and limitations of genetic testing to help you make the right decision.
After our team receives the results from genetic testing, our genetic counselor will contact you to schedule a third appointment. At that visit, our team provides counseling about how the results may modify your cancer risk, and whether this changes the health management plan outlined at your second appointment. These discussions are detailed; therefore, results are never disclosed by telephone.
Clinical Trials for Prevention and Detection for Cancer
A major focus of CREP is using research to find better ways to measure, prevent and manage genetic risk for cancer. Clinical trials allow doctors to evaluate promising new methods of cancer prevention, detection and treatment. If you are at high risk for cancer, our physicians will discuss with you any trials for which you may be eligible.
Payment for Services
Visits directly related to CREP are free. However, anyone at a significantly increased risk will need medical follow-up and ongoing monitoring. You will be billed standard outpatient visit fees after the initial assessment. We can assist you with determining your insurance coverage before deciding to schedule an appointment.
Genetic testing is provided through a commercial laboratory. We will also assist you with determining your insurance coverage for testing and providing letters of medical necessity to your insurer if required. All billing is handled directly with the commercial laboratory.
Schedule an Appointment
To learn more about CREP, contact our licensed, board-certified genetic counselor:
Cheryl Knight, MS, CGC
Cancer Risk Evaluation Program Coordinator
The Cancer Institute of Doylestown Hospital
Additional Cancer Resources
The Abramson Cancer Center's Oncolink is an award-winning website for the most current information on cancer risk, treatments and research advances. For more information visit What’s My Risk? Oncolink.