Best pedigree software for oncology 2026: cancer risk platforms, ranked

Short version. For pure cancer-risk model breadth, FamGenix is unmatched: BOADICEA v6, Tyrer-Cuzick v8, BayesMendel, Gail, Claus, and QRISK3 simultaneously. For BOADICEA authority, use CanRisk from Cambridge — it is the reference, endorsed by NICE, NCCN, and ESMO. For a general clinical platform with cancer in scope, Phenotips and Progeny Clinical are mature choices. For NHS cancer services with FHIR, TrakGene. For AI-assisted cancer counselling and BayesMendel integration, Evagene. Evagene does not top the pure model-breadth ranking — FamGenix does — and we say so honestly.

Hereditary cancer counselling is the workflow where pedigree software matters most, because a pedigree is both the input to risk models and the document on which guideline-based screening recommendations rest. The choice of tool therefore has direct clinical consequence. Get the model selection right first, then get the workflow fit right.

How we evaluated

• Risk-model breadth. BOADICEA v6, Tyrer-Cuzick v8, BRCAPRO, MMRpro, PancPRO, Gail, Claus, QRISK3 — which run directly from the pedigree?
• Guideline alignment. NCCN, NICE, ESMO criteria — explicitly supported or left to clinician judgment?
• Cancer-specific workflow. Case family history, ages at diagnosis, cancer site coding, bilateral involvement, second primaries.
• Batch screening. Can the tool flag which patients cross testing-eligibility thresholds without manual per-model runs?
• Reporting. Patient-friendly letters, clinician summaries, test-ordering integration.
• Cascade. Tracking at-risk relatives and contact status.
• Compliance and residency. HIPAA, GINA, data residency for multi-national services.

The tools, ranked by oncology fit

1. FamGenix — widest cancer risk-model coverage

FamGenix leads on the one dimension that matters most in pure oncology: running every major hereditary cancer risk model simultaneously from one pedigree. BOADICEA v6 (breast, ovarian), Tyrer-Cuzick v8 (breast), BayesMendel (BRCAPRO, MMRpro, PancPRO), Gail (breast), Claus (breast), QRISK3 (cardiovascular baseline) — all run at once. 4 of the top 10 US cancer centres use it. HIPAA and GINA compliant. Regional data residency (US, Canada, UK-EU, Australia). A free Individual tier plus a paid Provider Portal. Launched in 2021.

Where it struggles: outside cancer it is deliberately thinner than a general clinical genetics platform. Provider Portal pricing is on application. Price: free Individual; Provider Portal on application. Best for: dedicated cancer genetics services, familial cancer clinics, oncology counselling units. See FamGenix vs Evagene.

2. CanRisk — BOADICEA authority

CanRisk is the Cambridge web interface to BOADICEA and CanRisk-Prostate. Free with registration. Backed by the University of Cambridge, Cancer Research UK, Wellcome, and Genome Canada. Endorsed by NICE, NCCN, and ESMO. Available in seven languages. The reference free tool for BOADICEA.

Where it struggles: CanRisk is primarily a risk calculator with a pedigree interface attached, not a comprehensive pedigree manager with cascade, letters, EHR integration, and case workflow. It is most effective used alongside a general pedigree tool, with CanRisk invoked for BOADICEA authority. Price: free with registration. Best for: breast and ovarian risk consultations, publications requiring BOADICEA authority, hereditary prostate risk.

3. Phenotips — best general clinical platform with cancer in scope

Phenotips runs multiple simultaneous cancer risk models (the public site does not enumerate the full set) and brings the strongest compliance posture of any platform here: GDPR, DSPT, HIPAA, CE+. 100,000+ patient records, 500+ specialists, 60+ countries. Used at Addenbrooke's. Explicitly LGBTQIA+ inclusive — meaningful in cancer counselling for same-sex couples and transgender patients.

Where it struggles for oncology specifically: the phenotype-first workflow is tuned for rare disease more than cancer. The full cancer model set is not publicly listed. $399/month Research tier with $25/user additional; enterprise on application. Price: from $399/month; enterprise on application. Best for: academic medical centres running mixed cancer and rare disease, services where LGBTQIA+ inclusive symbology is a priority. See Phenotips vs Evagene.

4. Progeny Clinical — mature cancer counsellor default

Progeny Clinical has integrated cancer risk calculators and has been in cancer counselling since 1996. 800+ institutions. HIPAA compliant. Letter generation and test ordering are built in. Cloud or premium on-premise.

Where it struggles: user-reported friction on consanguinity UX, moving family members in complex pedigrees, rising prices. Pricing on application. Its test-ordering integration is tied to Ambry Genetics, which some services weigh as a test-ordering neutrality consideration. Price: on application. Best for: established cancer genetics services valuing maturity and letter-template depth. See Progeny vs Evagene.

5. TrakGene — best for NHS cancer services

TrakGene integrates CanRisk and the Gail model, is clinician-built, HL7 FHIR native, and runs in NHS, NIH, and Geisinger environments. 800+ users across 50+ genetics services. Cloud or on-premise. ClinVar integration. AI copilot.

Where it struggles: no free tier, pricing on application. The AI copilot is vendor-mediated rather than BYOK. Price: on application. Best for: NHS cancer genetics services, FHIR-first public-sector cancer units. See TrakGene vs Evagene.

6. Evagene — best for AI-assisted cancer counselling with BYOK LLMs

Evagene (our product) runs BRCAPRO (breast, ovarian), MMRpro (Lynch), and PancPRO (pancreatic) from the BayesMendel suite directly from the pedigree, plus Mendelian inheritance for monogenic non-cancer cases. A 200+ disease catalogue with ICD-10 and OMIM coverage. Batch risk screening flags cases where family history crosses a configurable risk or testing-eligibility threshold across the full disease catalogue — useful for services that want proactive flagging rather than per-case model runs. AI interpretation with BYOK (Anthropic Claude, OpenAI GPT), Analysis Templates for oncology-specific prompts, and an MCP server for Claude Desktop and Claude Code.

Where we struggle for oncology: we do not match FamGenix's concurrent cancer model breadth today. We run BRCAPRO, MMRpro, and PancPRO — not Tyrer-Cuzick or BOADICEA natively. For breast-risk-dominant services, FamGenix or CanRisk are a better model fit; for BayesMendel-first services or those wanting AI-assisted counselling with BYOK, Evagene is the strongest current pick. Price: free Alpha via waiting list. Best for: cancer services using BayesMendel, teams integrating AI into cancer counselling, services wanting programmatic access to pedigree data.

Comparison matrix

Based on publicly advertised capabilities April 2026. "Likely" indicates the vendor lists multiple models without enumerating the specific set.

Which to choose if...

• You run a dedicated familial breast or ovarian cancer clinic: FamGenix for breadth, CanRisk for BOADICEA authority. Consider using both.
• Your service is Lynch syndrome or pancreatic cancer-focused: Evagene (MMRpro, PancPRO) or FamGenix.
• You are an NHS cancer genetics service: TrakGene with CanRisk integration.
• Your cancer service is one part of a general clinical genetics practice: Phenotips or Progeny Clinical.
• You want AI-assisted cancer counselling with your own LLM keys: Evagene.
• You need a free option for hereditary breast and ovarian risk: CanRisk plus FamGenix Individual.
• You need NCCN-criteria screening explicitly: FamGenix and Progeny Clinical emphasise guideline alignment.
• Multi-national cancer service with regional data residency: FamGenix (US, Canada, UK-EU, Australia).

Frequently asked questions

Related guides

• Best hereditary cancer risk tools
• Best pedigree software for genetic counsellors
• Best pedigree software for hospitals
• Best pedigree software 2026
• Hereditary cancer risk assessment
• FamGenix vs Evagene