What’s happening
In a bold, multi-year initiative, Princess Margaret Cancer Centre plans to screen up to 100,000 Ontarians over the next five years for genetic conditions that raise the risk of hereditary cancers and a condition linked to high cholesterol and heart disease. The project aims to shift care from reactive treatment to proactive prevention by identifying individuals who carry high-risk genetic variants.
Why this matters
Hereditary cancers account for a significant portion of cancer diagnoses. People who inherit certain gene mutations have a substantially higher lifetime risk of cancers such as breast, ovarian, colorectal, and prostate cancer. Early identification can guide personalized screening, prevention strategies, and informed decision-making about interventions that could reduce risk.
Separately, the program will screen for familial hypercholesterolemia (FH), a common genetic condition that causes very high cholesterol levels from birth and markedly increases the risk of early heart disease. Detecting FH early means families can pursue targeted therapies, lifestyle changes, and regular lipid monitoring to lower lifetime cardiovascular risk.
How the screening works
The initiative centers on genetic testing with consent and appropriate counseling. Participants will be offered a DNA test that analyzes panels of genes known to be associated with hereditary cancer syndromes and FH. When a pathogenic variant is found, clinicians can tailor surveillance plans, such as earlier and more frequent imaging, colonoscopies, or breast MRI screening, depending on the gene involved.
It is essential to note that testing is voluntary and paired with genetic counseling. The aim is to empower people with information while ensuring privacy, ethical considerations, and robust support networks for decision-making and psychological well-being.
Implications for families and communities
Because many genetic conditions are inherited from parents to children, the screening has potential benefits for entire families. If a person tests positive for a hereditary cancer gene, relatives may also consider testing to better assess their own risks. Similarly, identifying FH allows family members to be checked and treated early, reducing the odds of a heart attack or stroke later in life.
The program also highlights health equity: researchers and clinicians are working to ensure access for diverse populations, address potential disparities, and provide culturally appropriate counseling and resources across Ontario.
What experts say
Experts emphasize that precision medicine—using an individual’s genetic makeup to guide care—can transform outcomes. However, the success of the screening hinges on high-quality genetic testing, comprehensive counseling, and clear pathways to preventive services. Researchers are evaluating how best to integrate results into routine care, minimize anxiety, and avoid unnecessary interventions.
What to expect next
Over the next five years, participating clinics and medical centers will enroll eligible adults and, in some cases, family members. If you’re interested, speak with your family physician or a genetic counselor about whether genetic screening for hereditary cancer risk or FH is appropriate for you. Public education campaigns will accompany the rollout to explain benefits, risks, and privacy protections.
Frequently asked questions
- Is the program open to everyone? Availability and eligibility may vary by province and program design; check with local healthcare providers for details.
- Will results be kept private? Privacy and data security are central concerns, with strict safeguards and consent processes.
- What happens if a pathogenic variant is found? You’ll receive genetic counseling and a tailored plan for screening and prevention.
