Alternatives to CanRisk: a 2026 field guide for clinical pedigree software

Looking for an alternative to CanRisk? Here's an honest field guide. CanRisk is a free web tool from the University of Cambridge that runs the BOADICEA model for breast and ovarian cancer risk (with a prostate model added in more recent versions). It is endorsed by NICE and NCCN and is the canonical BOADICEA implementation. For the BOADICEA calculation itself, CanRisk is the gold standard — other tools either license BOADICEA from the same group or use a different model.

The reason teams look for alternatives is not that CanRisk is flawed — it is that CanRisk is intentionally narrow. It is a risk calculator, not a full pedigree management system. It does not persist patient records across visits, it does not integrate with an EHR in a clinical workflow sense, it does not cover non-breast-ovarian-prostate cancers, it does not offer AI interpretation or programmatic access, and it does not handle the broader clinical genetics workload of a service. For BOADICEA specifically, CanRisk remains the reference. For a clinical platform that can hold pedigrees and run multiple risk models plus broader workflow features, you need something else.

This page covers four credible alternatives — FamGenix, Evagene, Phenotips, and TrakGene. Evagene publishes this site; we are plain about its current BOADICEA gap (it uses BRCAPRO, not BOADICEA) and about where it compares.

Short version. For canonical BOADICEA risk, keep using CanRisk. For BOADICEA inside a clinical product with other cancer risk models, FamGenix. For a full pedigree platform with BRCAPRO/MMRpro/PancPRO, Mendelian inheritance calculators, AI interpretation, and programmatic access (accepting BOADICEA is not currently included), Evagene. For HPO-driven rare disease with cancer risk modelling behind an enterprise contract, Phenotips. For FHIR-integrated clinical genetics, TrakGene.

Why teams look for alternatives to CanRisk

The first reason is scope. CanRisk calculates BOADICEA and related risks from a pedigree entered through its structured interface. It does not store patient records for ongoing clinical management, it does not maintain a pedigree library across visits, and it does not handle documentation, reporting, or anything outside the risk calculation itself. For services that need to treat the pedigree as a longitudinal clinical artefact, CanRisk is a calculator used inside a workflow rather than the workflow itself.

The second reason is model coverage. BOADICEA addresses breast, ovarian, and (in recent versions) prostate cancer risk very well. Services who see mixed presentations — Lynch syndrome, pancreatic risk, general Mendelian disease, cardiac genetics, rare disease — need tools that cover those as well. The third reason is the surrounding clinical workflow: AI-assisted report drafting, EHR integration, patient portals, programmatic access for internal tools, and data portability for multi-institution care. CanRisk does not attempt these; a full clinical platform does.

Four alternatives worth evaluating

FamGenix

FamGenix is the clinical product closest to CanRisk in cancer-risk focus, with a different shape. It runs BOADICEA v6, Tyrer-Cuzick v8, Gail, Claus, and QRISK3 simultaneously from a single pedigree inside a clinical workflow product. It offers a free Individual tier and tiered pricing.

Where FamGenix fits: services whose need is BOADICEA plus neighbouring cancer-risk models inside a workflow product with persistent pedigrees, documentation, and clinical reporting. Where CanRisk remains stronger: CanRisk is the canonical BOADICEA reference with direct NICE/NCCN endorsement, free at the point of use, and maintained by the Cambridge group that develops the BOADICEA model itself. For a canonical BOADICEA run on an occasional case, CanRisk is the simpler tool; for a service running BOADICEA across many cases alongside pedigree management, FamGenix bundles more.

Evagene

Evagene is a browser-first clinical-grade pedigree platform with a different cancer-risk set. Clinically it covers gesture-driven pedigree drawing with NSGC/ISCN notation, a 200+ disease catalogue annotated with ICD-10 and OMIM, BRCAPRO, MMRpro, and PancPRO from the BayesMendel suite, Mendelian inheritance calculators for AD, AR, and XR conditions, batch risk screening across the disease catalogue, a karyogram viewer, and consanguinity detection via Wright's coefficient.

Where Evagene differs from CanRisk: Evagene is a full pedigree management platform with persistent patient records, multi-disease risk screening, and a modern platform surface. AI clinical interpretation uses bring-your-own-key (BYOK) LLMs for Anthropic Claude and OpenAI GPT. Analysis Templates codify house-style AI-drafted reports. An MCP server exposes 11 pedigree tools to Claude Desktop and Claude Code. A scoped REST API, HMAC-SHA256 webhooks, and an embeddable pedigree viewer (iframe/SVG/JS) support programmatic integration.

Where Evagene falls short against CanRisk's specific strength: Evagene does not currently run BOADICEA. It uses BRCAPRO — a peer Bayesian Mendelian model — for breast and ovarian risk. BRCAPRO and BOADICEA are both respected in the literature but they are not identical and not drop-in substitutes. For services whose clinical governance requires specifically BOADICEA (for example, services where local protocols reference NICE CG164 or NCCN BOADICEA-specific thresholds), Evagene does not satisfy that requirement today. Some services use Evagene as the pedigree platform and CanRisk for BOADICEA specifically, a dual-tool workflow that is common in practice. Evagene Alpha is free via the waiting list.

Phenotips

Phenotips is an enterprise Genomic Health Record platform with Human Phenotype Ontology at its core. It advertises multiple simultaneous cancer risk models without publicly enumerating the set, and it is particularly strong in undiagnosed rare disease and phenotype-driven gene suggestion.

Where Phenotips fits as a CanRisk alternative: services whose work is broader than cancer risk and centres on phenotype-driven diagnostics, with cancer risk as one of several components. Where it falls short: CanRisk's canonical BOADICEA position is not matched by Phenotips's unspecified risk-model list, and Phenotips's enterprise sales-led procurement is a heavier route than CanRisk's free web access.

TrakGene

TrakGene is a clinician-built clinical genetics platform with HL7 FHIR-first integration and customers including NIH, NHS services, and Geisinger. It is a broad clinical genetics product rather than a cancer-risk calculator.

Where TrakGene fits: services that want FHIR-integrated clinical genetics with pedigree management alongside their cancer-risk work, where CanRisk provides the BOADICEA calculation separately. Where it falls short: TrakGene does not publicly advertise BOADICEA or the other canonical cancer-risk models, so it is not a direct CanRisk replacement for the risk calculation itself.

Feature comparison matrix

Compiled from publicly available product pages as of April 2026. "—" means not publicly advertised.

How to choose

Canonical BOADICEA needed. Keep using CanRisk. It is free, authoritative, and maintained by the BOADICEA development group.

BOADICEA inside an integrated cancer-risk clinical product. FamGenix.

Full pedigree platform with BayesMendel models, Mendelian calculators, AI, and API (accepting BOADICEA is not currently included). Evagene. Many services use Evagene as the pedigree platform and CanRisk for BOADICEA specifically.

Phenotype-first rare disease with cancer as one component. Phenotips.

FHIR-native clinical genetics platform with external BOADICEA via CanRisk. TrakGene.

Frequently asked questions

Further reading

• Hereditary cancer risk assessment
• Phenotips vs Evagene
• Progeny vs Evagene
• Clinical genetics pedigree tools: a field guide
• Mendelian inheritance calculator
• The Evagene platform layer (API, MCP, webhooks)