A 45-year-old woman has a mother diagnosed with colorectal cancer at age 55 and a maternal aunt with endometrial cancer at age 60. What is the most appropriate initial step regarding genetic testing for hereditary cancer syndrome?
A. Advise increased surveillance with colonoscopy every 5 years starting now.
B. Order germline testing for MLH1, MSH2, MSH6, and PMS2 genes.
C. Referral to a familial cancer clinic for risk assessment and counselling.
D. Order tumour testing for microsatellite instability (MSI) and immunohistochemistry (IHC).
E. Reassure the patient that this family history is not strongly suggestive of a hereditary syndrome.
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