Evagene for oncologists

In the oncology clinic, family history is rarely the centre of the conversation. It sits alongside staging, treatment planning, toxicity review, and survivorship. Yet for a significant fraction of your patients — perhaps 5 to 10% in breast, 3 to 5% in colorectal, higher in pancreatic and ovarian — a hereditary cancer syndrome is in play, and the right time to recognise it is often early, while treatment decisions are still being made. The window for acting on a germline finding (PARP inhibitor eligibility, cascade testing of relatives, risk-reducing surgery options for the patient, screening of unaffected carriers) closes as the treatment pathway narrows.

Evagene is a pedigree tool designed to sit comfortably in the oncology workflow rather than require you to adopt a separate clinical-genetics discipline. In the time you have between seeing a patient's notes and the MDT meeting — or during the meeting itself — you can capture the family history, run batch risk screening, and generate a clean paragraph for the MDT minutes that either closes out the hereditary question or forwards it to clinical genetics with a structured referral.

The oncologist workflow

A new breast patient arrives in your clinic with a referral from the breast surgeon. You have the pathology, the imaging, the performance status, and a free-text line in the referral letter: "mother had breast cancer in her fifties, aunt and grandmother also affected." Before you can decide on neoadjuvant chemotherapy, PARP inhibitor sequencing, or surgical planning, the hereditary question hovers in the background. Does this patient warrant germline BRCA testing? Would a hereditary finding alter the plan?

You have roughly ten minutes, between clinic patients, to decide whether to send the patient to genetics, order direct-to-patient testing via the oncology team, or mark the family history as insufficient for hereditary referral. The same question repeats in the colorectal clinic (Lynch syndrome), the pancreatic clinic (BRCA / PALB2 / ATM / Lynch), the ovarian clinic (BRCA / Lynch / BRIP1 / RAD51). At MDT, two or three patients per meeting have a family history line worth discussing; half the time the MDT defers the decision because there is not enough structured information to act on.

The cost of getting this wrong varies. Missing a BRCA carrier in a platinum-sensitive ovarian patient means missing PARP eligibility. Missing Lynch in a colorectal patient means the relatives do not get surveillance. Missing Li-Fraumeni in a young sarcoma patient can affect radiotherapy decisions. At the other end, referring everyone with "some family history" to clinical genetics clogs the genetics service and delays the patients who actually need counselling.

What you need is a way to turn a free-text family history into a structured pedigree and a set of risk model outputs, quickly, inside your own workflow, without scheduling a separate counselling appointment first.

What oncologists need from pedigree software

• Speed — the ability to capture a three-generation family history in a few minutes, not a full counselling hour.
• Published risk models — BRCAPRO, MMRpro, PancPRO, not a proprietary black box.
• Threshold-aware screening — something that tells you whether the patient crosses testing criteria (for example, NCCN hereditary breast/ovarian or Lynch criteria) rather than leaving you to cross-check manually.
• MDT-ready summaries — a paragraph you can paste into the minutes, not a twenty-page counselling letter.
• Clean referrals — an exportable pedigree and risk report that the receiving genetics service can read without redoing the intake.
• No installation or IT project — browser-based, accessible from the MDT room or your desk.
• Data portability — PDF, PNG, SVG, GEDCOM, so the data moves with the patient.

How Evagene supports oncologists

Rapid family history capture

You do not need to draw a full four-generation pedigree for MDT. Evagene's gesture drawing and keyboard shortcuts let you enter the proband, parents, siblings, children, and where needed the aunts and uncles on each side, in the time it takes to review the referral letter. Affected individuals are annotated with ICD-10 / OMIM codes from the 200+ condition catalogue; ages at diagnosis and deaths are entered inline. For an oncology context, most of what you need lives in that immediate family.

Batch hereditary cancer risk screening

Once the pedigree is built, batch risk screening runs every applicable BayesMendel model simultaneously. BRCAPRO returns the proband's probability of a pathogenic BRCA1/BRCA2 variant and her lifetime breast/ovarian cancer risk; MMRpro returns the equivalent for the mismatch repair genes and Lynch-associated cancers; PancPRO does the equivalent for pancreatic. The screen also highlights conditions where the family's pattern crosses a configurable threshold — so you know whether to flag the case for testing, for genetics referral, or for "not hereditary, carry on."

A fuller treatment of the clinical logic sits in our hereditary cancer risk assessment guide; the batch screening feature is unusual in the category — it inverts the normal clinician-suspects-condition-then-runs-model flow into software-surfaces-what-you-should-consider, which is exactly the flow an oncologist benefits from when family history is not the centre of attention.

AI-drafted MDT summaries

For the MDT minutes, you do not need a counselling letter — you need a single paragraph that captures the hereditary question, the model outputs, and the recommendation. Evagene's AI interpretation, running on your own LLM key (Anthropic Claude or OpenAI GPT, BYOK with Fernet encryption), drafts that paragraph automatically. Analysis Templates let your MDT standardise the structure so every hereditary entry in the minutes reads the same: context, family history, model outputs, threshold outcome, recommended next step.

Structured referral to clinical genetics

When the MDT decides to refer, you export the pedigree as PDF (or as GEDCOM if the receiving service also uses Evagene) and the risk report as PDF, and attach both to your referral. The clinical genetics service receives a structured pedigree rather than a free-text family history, which reduces the intake time on their end and avoids asking the patient to retell the family story from scratch. Where both services use Evagene, the pedigree can be shared directly — see our clinical geneticists page for the receiving workflow.

A tool that respects your time

Evagene is browser-based. No installation, no local configuration. Log in from your desk, the MDT room, the clinic terminal, or your home setup. Pedigrees are stored server-side and retrievable across sessions. For oncology contexts where a patient is seen multiple times and new family history occasionally surfaces (a sibling diagnosed later in life, an additional cousin), the pedigree is updatable without restarting.

A typical oncologist session in Evagene

Step 1. Open a pedigree for the MDT case. Create a new pedigree with the patient as proband; enter age, diagnosis, and staging from the oncology record.

Step 2. Capture first- and second-degree family history. Add parents, siblings, children, and where relevant maternal and paternal aunts/uncles and grandparents. Annotate each affected relative with a condition and age at diagnosis.

Step 3. Run batch risk screening. One click runs BRCAPRO, MMRpro, PancPRO, and the full catalogue screen. The results panel shows carrier probabilities and flags any conditions crossing threshold.

Step 4. Generate the MDT summary. Apply your MDT Analysis Template to draft a one-paragraph AI interpretation. Review, edit, and copy into the MDT minutes.

Step 5. Refer or close out. If referring, export the pedigree and risk report as PDF, attach to the referral, and the clinical genetics service receives a structured starting point. If not referring, the pedigree and report sit in the oncology record as evidence of the decision.

Frequently asked questions

Further reading

• Hereditary cancer risk assessment
• Clinical genetics pedigree tools: a field guide
• Evagene for clinical geneticists
• Evagene for general practitioners
• Pedigree drawing software
• The Evagene platform