Men and Hereditary Cancer: Why Genetic Testing Isn't Just a Women's Health Topic

By Amanda Shrewsbury, MS, CGC

When people hear "genetic testing for cancer risk," they often think of breast and ovarian cancer first. The focus on BRCA and the stories of women making difficult decisions about screening and prevention has been enormously important and has saved countless lives.

What hasn't gotten the same attention is that men carry hereditary cancer variants at exactly the same rate as women. They pass them to their children at the same rate. And for several cancers, including prostate, colorectal, pancreatic, and even breast cancer, men with these variants face meaningfully elevated risks that change how they should be screened and managed.

The reality is that many men never find out. Research consistently shows that male relatives are less likely to be informed about a family's genetic test result and less likely to pursue testing themselves. Not because they don't care, but because the conversation around hereditary cancer hasn't yet expanded enough to include them.

Do Men Get Hereditary Cancer?

Yes. Hereditary cancer syndromes don't discriminate by sex. Many of the genes involved, including BRCA1, BRCA2, and the mismatch repair genes associated with Lynch syndrome, are located on non-sex chromosomes (autosomes), which means they follow the same inheritance pattern in men and women. These are among the most well-studied hereditary cancer genes, but there are others (such as ATM, CHEK2, and PALB2) that also carry cancer risks for men. If a parent carries a pathogenic variant (a disease-causing DNA change) in one of these genes, each child, son or daughter, has a 50% chance of inheriting it.

Men don't just carry these variants silently. They face real, clinically significant cancer risks that warrant specific screening protocols.

What Cancers Are Men With BRCA Variants at Risk For?

The BRCA genes are best known for their association with breast and ovarian cancer in women, but they carry important risks for men as well.

Prostate cancer is the most significant BRCA-associated cancer risk for men. In the general population, a man's lifetime risk of prostate cancer is about 11–16%. For men with a BRCA2 variant, that risk rises to approximately 19–61%, and these cancers tend to be more aggressive and diagnosed at younger ages. BRCA1 variants also increase prostate cancer risk, though the association is weaker, with estimates ranging from about 7–26% (Li et al., 2022; Nyberg et al., 2020; NCI, 2024).

NCCN guidelines recommend that men with BRCA2 variants begin prostate cancer screening at age 40, including PSA blood tests. Screening is also considered for men with BRCA1 variants.

Male breast cancer is rare in the general population (lifetime risk of about 0.1%), but BRCA variants increase that risk substantially. Men with BRCA2 variants face an estimated 5–10% lifetime risk of breast cancer, while BRCA1 carriers face about 1–5%. NCCN guidelines recommend that male BRCA carriers begin clinical breast exams at age 35 and consider screening mammography starting at age 50 (or 10 years before the earliest male breast cancer in the family).

Pancreatic cancer risk is also elevated. Men with BRCA1 variants have approximately a 2–3% lifetime risk, and those with BRCA2 variants face about 3–5%, compared to roughly 1.7% in the general population.

Melanoma risk may also be modestly increased, particularly in BRCA2 carriers, though the evidence is less definitive.

What About Lynch Syndrome in Men?

Lynch syndrome affects men at least as much as women when it comes to colorectal cancer, and possibly more. Men with MLH1 or MSH2 variants face a lifetime colorectal cancer risk of approximately 50–80% under retrospective estimates, which is at the higher end of the range compared to women with the same variants.

Men with Lynch syndrome are also at increased risk for stomach cancer (5–8%), urinary tract cancer (up to 8%), small bowel cancer, and pancreatic cancer. These risks are gene-specific and should be managed with an individualized surveillance plan developed with a genetic counselor and care team. (For a detailed breakdown of Lynch syndrome risks by gene, see our guide: Lynch Syndrome Explained.)

The screening protocols for Lynch syndrome are the same for men and women when it comes to colonoscopy: every 1–2 years starting at age 20–25 for MLH1/MSH2/EPCAM carriers, or every 1–3 years starting at age 30–35 for MSH6/PMS2 carriers. Upper endoscopy every 2–4 years starting at age 30–40 is also recommended. And daily low-dose aspirin may reduce colorectal cancer risk by approximately 50%, based on the CAPP2/3 trial data.

Why Are Men Less Likely to Get Tested?

The research on this is consistent. Across hereditary cancer syndromes, male relatives are less likely to be informed about a family variant, less likely to pursue genetic counseling, and less likely to complete cascade testing.

The reasons are mostly about awareness, not biology. Because hereditary cancer testing is most closely associated with breast and ovarian cancer in the public conversation, men may not realize it applies to them. Family members sharing results may not think to prioritize male relatives. Healthcare providers may not refer men for genetic counseling as readily as they refer women.

None of these are good reasons to skip testing. A man who carries a BRCA2 variant and doesn't know it misses the opportunity for prostate cancer screening that could catch an aggressive cancer early. A man who carries an MSH2 variant and doesn't know it may not start colonoscopy until the standard age of 45, missing years of recommended surveillance that should have begun at 20–25.

Should You Get Tested?

If any of the following apply to you, genetic testing may be recommended:

You have a close relative (parent, sibling, child) with a known hereditary cancer variant
You have a family history of early-onset cancers (before age 50), especially colorectal, prostate, breast, or pancreatic cancer
You have multiple relatives on the same side of the family with cancer
You have a personal history of male breast cancer, early-onset or aggressive prostate cancer, or pancreatic cancer
You are of Ashkenazi Jewish descent (where BRCA variants are more common, affecting about 1 in 40 individuals)

If you're not sure whether your family history suggests hereditary cancer risk, a genetic counselor can help you assess it. That's one of the primary things we do in the pre-test session at ClearPath Genetics.

What Happens If You Test Positive?

A positive result means you and your care team can build a screening plan tailored to your specific variant, your age, and your family history. For men, this typically includes some combination of prostate cancer screening, clinical breast exams, and potentially pancreatic cancer surveillance, depending on the gene and family history involved.

It also means your family members, including your siblings, children, and parents, may benefit from cascade testing. Each first-degree relative has a 50% chance of carrying the same variant. Sharing your result could change the course of their health.

For a deeper understanding of what positive, negative, and VUS results mean, see: What Your Genetic Test Results Actually Mean.

This Applies to You

If you're a man reading this, the headline is simple: hereditary cancer variants don't care about your sex. They affect men and women equally when it comes to inheritance, and they carry real cancer risks for men that can be identified, monitored, and managed.

If you're a woman reading this and thinking about a father, brother, son, uncle, or nephew who might benefit from knowing about your family's genetic result, sharing that information is one of the most important things you can do. (For practical guidance on how to approach that conversation, see: How to Talk to Your Family About Genetic Testing.)

Have a question? Reach out anytime:

Email: hello@clearpathgenetics.com
Text or call: +1 (720) 799-0730

References

Li, S., Silvestri, V., Leslie, G., et al. (2022). Cancer risks associated with BRCA1 and BRCA2 pathogenic variants. Journal of Clinical Oncology, 40(14), 1529–1541.

National Cancer Institute. (2024). BRCA gene changes: Cancer risk and genetic testing fact sheet. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet

National Comprehensive Cancer Network. (2026). Genetic/familial high-risk assessment: Breast, ovarian, pancreatic, and prostate (Version 3.2026). https://www.nccn.org

Nyberg, T., Frost, D., Barrowdale, D., et al. (2020). Prostate cancer risks for male BRCA1 and BRCA2 mutation carriers: A prospective cohort study. European Urology, 77(1), 24–35.

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