Prevention

Gastrointestinal Cancer Prevention Program

At Seattle Cancer Care Alliance (SCCA), we not only treat patients who have gastrointestinal (GI) cancers — we help prevent people from getting these cancers of the digestive system in the first place. 

If genetic testing shows you are at high risk for a GI cancer, our team of gastroenterologists, genetic counselors and medical geneticists at the Gastrointestinal Cancer Prevention Program can expertly assess, screen and monitor you in order to reduce that risk. 

Programs for screening and surveillance (monitoring) of GI cancers have been found to detect cancer at an earlier stage, when it is curable. We can help assess your personal risk of cancer and design a personalized prevention plan for you. 

FAQs about GI cancer prevention

Why is prevention especially important for people with a genetic risk of a GI cancer? ​​​​​​​

Some cancers show early warning signs; GI cancers do not. In fact, most people with an undiagnosed GI cancer don’t experience health problems until the cancer reaches an advanced stage. That’s why a prevention plan is so important for people with a genetic mutation (change) that puts them at high risk. If a cancer or precancerous growth does begin to develop, it can be caught in an early stage, when it can most easily be treated.

Who do we see at the clinic?

If you are referred to the GI Prevention Clinic at SCCA, it means that you have had genetic testing and have already been identified as someone who is at high risk for a GI cancer, either because of a strong family history of GI cancer or because of your test results. 

We work with people like you who have been referred to us by their primary care physician or another medical provider, either from within SCCA or another medical system. People who know they have a strong family history of GI cancer can also contact us directly and make an appointment without a referral. 
 

What does “a strong family history of GI cancer” mean?

A strong family history means that two or more close relatives on the same side of your family have had a GI cancer, especially if the cancer was diagnosed before age 50. 
You are also at high risk if you have had:

  • A precancerous GI polyp before age 40
  • More than 10 precancerous GI polyps at any age
  • A GI cancer before age 50
  • More than one primary cancer, one of which was a GI cancer, at any age
  • An abnormal result on a genetic test for a hereditary GI cancer syndrome, such as Lynch syndrome (HNPCC) or familial adenomatous polyposis (FAP)

What happens at your first appointment

Before your visit to the Gastrointestinal Cancer Prevention Program at SCCA, our GI experts will review your medical records, your family history of GI and other cancers and the results of any tests you may have had elsewhere. 

Once we have this information, we will schedule a time for you to come in to discuss your results and work with you to build your personalized prevention program. Depending on your unique risk profile, you may meet with one or more providers — such as a gastroenterologist, medical geneticist, genetic counselor or nutritionist — during this appointment. Your appointment will last about two hours.

Your plan will be as unique as you are. For instance, if your test results show you are at risk for colon cancer, your plan may include a yearly colonoscopy. If you have a different type of risk, our gastroenterologist might prescribe a medication. You might have surveillance and screening endoscopies done at SCCA or the University of Washington Medical Center. Sometimes, we refer patients to the High-Risk Surveillance Clinic at SCCA for further care. 
 

What is included in my personalized prevention plan?
  • Information about hereditary and nonhereditary GI cancer risk factors
  • Strategies to lower your GI cancer risk
  • Information about clinical trials you are eligible to participate in through SCCA and our partners at Fred Hutchinson Cancer Research Center, Seattle Children's and UW Medicine
  • A detailed letter summarizing your visit
What are some of the strategies that may be used to reduce my risk?
  • Screening by physical exam and imaging (colonoscopy, upper endoscopy or endoscopic ultrasound)
  • Risk-reducing surgery
  • Medicine to prevent cancer
“Just because you have a genetic susceptibility to a GI cancer doesn’t mean you have to get it. Our whole program is built around preventing cancer through surveillance.”
— Teri Brentnall, MD, Gastroenterologist

Care team

The Gastrointestinal Cancer Prevention Program team is made up of experts from a variety of specialties within SCCA. 

Gastroenterologist

Gastroenterologists are trained to diagnose and treat diseases of the gastrointestinal system, including cancers of the liver, pancreas, esophagus, stomach, colon, rectum and anus. At the GI Cancer Prevention Program at SCCA, our gastroenterologists educate patients and help them understand how their genetic risk affects the treatment of their blood cancer.

Medical geneticist

A medical geneticist is a physician who is specially trained to know what types of genetic tests to order for patients, as well as how to interpret the results. Testing for genetic disorders is complex and includes many different types of tests. Interpreting the results also requires specialized knowledge, because results are typically not simple or straightforward.

Genetic counselor

This specially trained health care provider helps you understand your risk of a genetic disorder. A genetic counselor can also determine if genetic testing could be helpful for you, based on your personal and family medical and health history. After you have had genetic testing, a genetic counselor can offer information and resources for prevention; connect you with prevention programs, such as those available at SCCA; and help with testing your family members, based on your results. SCCA Genetic Counseling Service providers are all licensed, board-certified genetic counselors.

Registered dietitian

Registered dietitians are credentialed food and nutrition experts. To earn this designation, they must undergo extensive training and formal education, including completing an internship and passing a national registration exam. Registered dietitians provide medical nutrition therapy which means they use an evidence-based approach to treat and help patients manage medical conditions through diet and nutrition. 

Registered nurse

Your nurse manages your care alongside your physician. They also assist with procedures and treatments. Nurses are resources for you and your caregiver. They answer questions and help with a wide range of topics, like how to cope with side effects or get other services you need at SCCA.

Patient care coordinator

Your patient care coordinator will likely be one of the first people you meet when you come to SCCA. They will gather your medical records and family health history and help guide you to the appropriate genetics or prevention care services within SCCA.

Find care team profiles

Meet the caring, dedicated people who take care of you and your family at SCCA.

Teresa A. Brentnall, MD
Physician
Gastroenterology
Heather H. Cheng, MD, PhD
Physician
Medical Oncology
Marianne Dubard-Gault, MD, MS
Physician
Genetics
William M. Grady, MD
Physician
Gastroenterology

Genetic counselors

SCCA Genetic Counseling Service providers are all licensed, board-certified genetic counselors.

Lauren Brown, MS, CGC

Lauren Brown provides counseling for a variety of hereditary cancer syndromes. She enjoys coming alongside patients to share meaningful and relevant genetic health information. She is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health. In her free time, Lauren enjoys biking and overlanding (a fusion of camping and off-roading).

Lauren Facchini, MS, CGC

Lauren Facchini provides counseling for a variety of hereditary cancer syndromes. She has a special interest in genitourinary malignancies and focuses on helping patients understand how genetic test results can impact their personal and family’s risk for disease. She is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health. 

Cynthia Handford, MSc, CGC, CCGC

Cynthia Handford has been a genetic counselor since 2007 and has worked in both clinical and laboratory settings. She has a special interest in hereditary cancer and enjoys helping patients and their families use genetic information to be proactive with their health. Cynthia is certified by the American Board of Genetic Counseling as well as the Canadian Association of Genetic Counsellors and licensed by the Washington State Department of Health.

Everett Lally, MS, CGC

Everett Lally provides counseling for a variety of hereditary cancer syndromes. He has a special interest in cancer genetics with a focus on gastrointestinal diseases and prostate cancer. He is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health. 

Mercy Laurino, MS, CGC, PhD

Mercy Laurino is a certified genetic counselor. She manages SCCA’s Breast and Ovarian Cancer Prevention Program, Gastrointestinal Cancer Prevention Program, Lung Cancer and Early Detection Program, as well as the Tobacco Cessation Counseling and the Genetic Counseling services. She is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health. She is the recent recipient of the International Leader award from the National Society of Genetic Counselors.

Lorraine Naylor, MS, CGC

Lorraine Naylor provides counseling to patients referred for a variety of inherited conditions. She has a special interest in cancer genetics, with a focus on gastrointestinal malignancies. She is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health.

Britta Sjoding, MS, CGC

Britta Sjoding is a certified genetic counselor and primarily provides cancer genetic counseling service to our SCCA community sites. Counseling patients regarding hereditary cancer syndromes since 2009, she is certified by the American Board of Genetic Counseling and licensed by the Washington State Department of Health.