Hereditary cancer risk assessment outreach

A short family history review in primary care is the first step the U.S. Preventive Services Task Force describes for women who may carry a harmful BRCA1 or BRCA2 gene change. Family medicine, internal medicine, OB-GYN and nurse practitioner led clinics can invite patients to that review, and breast centers and cancer programs can explain where it leads. It is also a topic where a careless line does real harm. An ad that says “find out your cancer risk in minutes” overstates what a questionnaire does, a form that sends family cancer history to an ad platform leaks genetic information, and a message aimed at everyone ignores the Task Force’s own advice against routine assessment for women without a family pattern. This guide covers what the Task Force recommends, what the brief assessment asks, how coverage works, why family history counts as genetic information under federal law, and how to write invitations and referral messages that stay accurate and calm.

Related topics have their own guides and are not repeated here. Test claims and privacy promises for testing services are covered in our guide to genetic testing marketing, breast imaging reminders in our guide to mammogram outreach, oncology programs in our guide to cancer center advertising, women’s health practices in our guide to OB-GYN practice marketing, and story and review rules in our guide to patient testimonials and before and after photos.

This is general information, not legal, billing or medical advice. Sources cited were checked on October 30, 2026: the USPSTF final recommendation BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing (August 20, 2019), whose page says the topic is being updated, read through an archived copy; the EEOC page Genetic Information Discrimination, read through an archived copy; 45 CFR 160.103 and 164.502, 42 U.S.C. 300gg-13, 16 CFR 255.2, 47 CFR 64.1200 and 15 U.S.C. 45; the HHS guidance on online tracking technologies; and the Google Ads personalized advertising policy. Coverage terms, Task Force grades and plan rules change, and state laws on genetic information, insurance and minors’ care differ. Have a health care attorney and your billing advisor review the program before you launch.

What the Task Force recommends

The USPSTF final recommendation dated August 20, 2019 has two parts. For women with a personal or family history of breast, ovarian, tubal or peritoneal cancer, or an ancestry associated with BRCA1 or BRCA2 gene mutations, it recommends that primary care clinicians assess them with an appropriate brief familial risk assessment tool. Women with a positive result on the tool should receive genetic counseling and, if indicated after counseling, genetic testing. That is a grade B recommendation.

For women whose personal or family history or ancestry is not associated with potentially harmful BRCA1 or BRCA2 mutations, the Task Force recommends against routine risk assessment, genetic counseling or genetic testing. That is a grade D recommendation. On October 30, 2026 the recommendation page said the topic is being updated and linked to an update in progress. We could not find a final updated statement on that date, so check the page before you launch and again before you renew any campaign.

The Task Force also says its recommendation applies to women, that its net benefit estimates are driven by biological sex rather than gender identity, and that people should consider their sex at birth to decide which recommendation best applies to them. Pages can repeat that in neutral words and leave the decision to the clinician and patient.

Say the order the Task Force uses: a brief family history assessment first, genetic counseling for a positive result, and testing only if indicated after counseling.
Do not invite every adult woman to be tested. The grade D half of the recommendation is part of the message.
Date the recommendation on the page (August 20, 2019) and say an update is in progress until the Task Force posts a final one.
Keep the Task Force’s own terms: risk assessment, genetic counseling, genetic testing.

What the brief assessment asks

The Task Force describes risk assessment as a multistep process that begins with identifying patients with family or personal histories of breast, ovarian, tubal or peritoneal cancer, family members with known harmful BRCA1 or BRCA2 mutations, or ancestry associated with those mutations. It found adequate evidence that familial risk assessment tools are accurate in identifying women with increased likelihood of a mutation, and that primary care clinicians can use them to guide referrals to genetic counseling.

When clinicians take the history, the Task Force says they should ask about specific types of cancer, primary cancer sites, which family members were affected, and whether relatives had more than one primary cancer. They should also ask about age at diagnosis, age at death and sex of affected relatives, both close (parents and siblings) and more distant (aunts, uncles, grandparents and cousins), on both the mother’s and the father’s side.

That list shapes what an invitation can honestly promise. The visit is a set of questions about relatives, followed by a conversation. It does not tell anyone whether they have a gene change, and it does not take minutes if the family history is long or unknown.

Tell patients what to bring: the names of relatives on both sides who had cancer, the type, and their age at diagnosis if known.
Say that “I don’t know” is a fine answer. Adopted patients and people out of touch with family can still have the conversation.
Mention the father’s side. Invitations that only say “if your mother had breast cancer” leave out half of the history the Task Force asks about.
Name the tool by its purpose (a short family history questionnaire), not by a brand or test name.

Who the message is for

Because the recommendation is split, the audience is narrower than “all women over 30.” The invitation fits women with a personal history of breast, ovarian, tubal or peritoneal cancer who have not been tested, women whose relatives had those cancers, women with a relative known to carry a harmful BRCA1 or BRCA2 change, and women with an ancestry the Task Force associates with those changes. The Task Force population also includes women who completed treatment for one of those cancers and are considered cancer free but have not been tested.

A good general message asks a question instead of making a claim: “Has anyone in your family had breast, ovarian, tubal or peritoneal cancer? Tell us at your next visit.” That reaches the right people without telling everyone they need a test.

Coverage, in the words of the statute

Under 42 U.S.C. 300gg-13(a)(1), group health plans and health insurance issuers offering group or individual coverage must cover, without cost sharing, evidence based items or services with an A or B rating in the current recommendations of the Task Force. The risk assessment and the counseling and testing steps in the grade B recommendation fall under that rule for plans it applies to. Grandfathered plans, short term plans and other coverage the statute does not reach can differ, and plans set their own criteria for testing.

Say “covered with no cost sharing by plans subject to the federal preventive services rule” or “check your plan,” never “free for everyone.”
Do not promise that a test will be covered. Testing is covered under the recommendation only if indicated after counseling, and plan criteria apply.
Have the front desk confirm benefits before a counseling or testing visit, and tell the patient what you found in writing.

Family history is genetic information

The EEOC explains that genetic information includes information about an individual’s genetic tests, the genetic tests of family members, and the manifestation of a disease or disorder in family members, which is family medical history. It says family medical history is in the definition because it is used to judge whether someone has an increased risk of a disease in the future. The HIPAA definition in 45 CFR 160.103 includes the same three parts.

Two federal rules follow from that. Under 45 CFR 164.502(a)(5)(i), a health plan, other than an issuer of certain long-term care policies, may not use or disclose protected health information that is genetic information for underwriting purposes. And under Title II of GINA, which the EEOC enforces, employers and other covered entities may not use genetic information in employment decisions, are restricted from requesting, requiring or purchasing it, and are strictly limited in disclosing it. Title I of GINA addresses health coverage.

Describe those protections exactly and stop there. Do not tell patients that their results “can never be used against them” or that the law covers every kind of insurance. If you want a sentence about protections, quote the scope and link the agency page. Our genetic testing marketing guide covers wording for GINA in more detail.

Forms, pages and tracking

A family history questionnaire on your site collects genetic information the moment a patient types a relative’s cancer into it. The HHS guidance on online tracking technologies explains how covered entities and their vendors handle protected health information collected through websites and apps. Treat the questionnaire like any patient form.

Do not run third party ad or analytics tags on the questionnaire, its thank you page or the booking page for a risk assessment visit.
Keep cancer types, relatives and test history out of URLs, page titles and form field names that a tag could read.
Collect the form inside your patient portal or a form tool covered by a signed agreement, and confirm in writing what that agreement covers.
Do not build ad audiences from people who opened the questionnaire. Google’s personalized advertising policy lists health among the restricted categories.
Ask only what the clinician needs. A form that asks for full names and birthdays of relatives collects more than the visit requires.

Words that invite, and words that alarm

The topic is frightening for patients who watched relatives go through cancer. Calm, specific wording works better than urgency, and it keeps the claims true.

Use: “A few questions about your family’s health history can show whether a conversation with a genetic counselor makes sense.” Avoid: “Find out your cancer risk in minutes.”
Use: “If the questionnaire suggests a higher chance of an inherited gene change, we will talk about genetic counseling.” Avoid: “Know if you carry the cancer gene.”
Use: “Testing, if your counselor and clinician recommend it.” Avoid: “Get tested today.”
Avoid naming a test brand, a lab or a result rate. Name the service: family history review, genetic counseling referral.
Avoid fear images and countdowns. No photos of patients in treatment, no “before it’s too late.”
Avoid stories that imply a result. Under 16 CFR 255.2(b), a consumer endorsement is likely read as what people will generally achieve, and claims must be truthful and substantiated under 15 U.S.C. 45.

Referral messages for genetic counseling

The Task Force says risk can be further evaluated with genetic counseling by suitably trained health care clinicians, followed by testing of selected high risk individuals and counseling about the results. Your referral message should say what happens next without predicting the outcome. These samples use placeholders; replace them with your own details.

After a visit: “[Practice name]: Thank you for going over your family history with [clinician name]. As discussed, we sent a referral for genetic counseling. If you have not heard from them by [date], call us at [phone]. Reply STOP to opt out.”
Invitation from a primary care practice: “[Practice name]: At your next visit we can review your family’s health history, on both sides of the family. Call [phone] or book in the portal. Reply STOP to opt out.”
Reminder for a scheduled review: “[Practice name]: Reminder of your visit on [date] at [time]. If you can, bring notes on your family’s health history. Call [phone] to change it. Reply STOP to opt out.”

Under 47 CFR 64.1200(a)(9)(iv), calls and texts to wireless numbers made by or on behalf of healthcare providers are exempt from prior express consent only when all of its conditions are met. They go only to the wireless number the patient provided, state the provider’s name and contact details, and are strictly limited to listed purposes, which include appointment and exam confirmations and reminders and wellness checkups. They contain no telemarketing, solicitation or advertising and no billing or other financial content, comply with HIPAA privacy rules, stay concise (generally 160 characters or fewer for a text), are limited to one message a day and three a week, and offer an easy opt out. A referral follow-up or a general invitation may not fit a listed purpose, so get the patient’s consent first or send it through the portal, and ask your attorney. Keep the words “cancer” and “gene” out of text previews where possible, since a lock screen is not private.

Illustration: two risk assessment pages

This is an invented example to show the difference, not a real practice. Page A leads with “Are you carrying a cancer gene? Find out in 5 minutes,” runs a pixel on its quiz, shows a stock photo of a patient in a head scarf and says “free genetic test.” Page B leads with “Talk with us about your family’s cancer history,” explains the three steps in the Task Force’s order, says who the review is for and who it is not for, names the 2019 recommendation and the update in progress, collects the questionnaire inside the patient portal with no ad tags, and says to check plan coverage. Page A overstates the tool, leaks genetic information and promises a price. Page B matches the sources.

Checklist before a risk assessment campaign goes live

The page cites the USPSTF 2019 recommendation with its date and notes the update in progress.
The steps appear in the Task Force order: assessment, counseling for a positive result, testing if indicated.
The grade D advice against routine assessment for women without a family pattern is reflected in who you target.
Coverage wording says “check your plan” and makes no free or price promise.
No ad or analytics tags run on the questionnaire, its thank you page or the booking page.
Family history fields stay out of URLs and page titles.
GINA and HIPAA wording quotes the scope of the law and promises nothing broader.
No test brand, lab name or result rate appears in ads or on the page.
Texts meet the healthcare message conditions in 47 CFR 64.1200(a)(9)(iv) and keep sensitive words off the preview.
A clinician and a health care attorney approved the page and the messages.

How we help

We build websites, local search, Google Ads, patient lead generation and AI front desk tools for independent practices and health businesses, including family medicine, internal medicine, OB-GYN and nurse practitioner led clinics. For hereditary cancer risk assessment outreach, that means a site that explains the Task Force steps in its own words, questionnaire and booking pages kept free of ad tags, and reminders that stay within the federal text rules and keep family history off the lock screen. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it.

What is a BRCA risk assessment?

In the USPSTF recommendation (August 20, 2019), it is a brief familial risk assessment done in primary care for women with a personal or family history of breast, ovarian, tubal or peritoneal cancer or an ancestry associated with BRCA1 or BRCA2 mutations. A positive result leads to genetic counseling, and testing if indicated after counseling.

Should every woman get a BRCA risk assessment?

No. The Task Force recommends against routine risk assessment, genetic counseling or genetic testing for women whose personal or family history or ancestry is not associated with potentially harmful BRCA1 or BRCA2 mutations (grade D).

What questions does the family history review ask?

The Task Force says clinicians should ask about the types of cancer, primary sites, which relatives were affected, whether a relative had more than one primary cancer, age at diagnosis, age at death and sex of affected relatives, on both sides of the family.

Is BRCA risk assessment covered by insurance?

42 U.S.C. 300gg-13 requires plans it applies to to cover grade A and B Task Force recommendations without cost sharing, and this recommendation is grade B. Grandfathered plans and other coverage can differ, and plans set criteria for testing, so check the plan.

Is family history protected health information?

Family medical history is part of the definition of genetic information in 45 CFR 160.103, and the EEOC page on GINA says the same. Under 45 CFR 164.502(a)(5)(i), health plans other than certain long-term care insurers may not use or disclose genetic information for underwriting.

Can we advertise a quick online cancer risk quiz?

We advise against it. The Task Force describes a brief tool used by clinicians to guide referrals, not a result in minutes, and an online quiz with ad tags can send genetic information to third parties. Collect the history inside the patient portal and discuss it at a visit.

Hereditary breast and ovarian cancer risk assessment outreach: family history questions, counseling referrals and privacy