September 17, 2026 - Dr. John D'Orazio, Dr. Amanda Harrington, James Collard (Project Inherited Cancer Risk)

LEXINGTON, Ky. (September 17, 2026) – When a child is diagnosed with cancer, families understandably want to know why. For some patients, part of the answer may be found in their genes.

Researchers and clinicians know that about one in every 10 patients diagnosed with cancer may have a genetic finding that helps explain why they developed the disease. But identifying those patients based solely on family history or other clinical clues can leave some inherited cancer risks undetected.

At UK Golisano Children’s, Project Inherited Cancer Risk is working to change that.

The project offers genetic testing to pediatric cancer patients to look for inherited genetic variants that may increase their risk for certain cancers. Identifying those variants can provide information that affects a patient’s treatment and long-term surveillance while also carrying potentially important implications for parents, siblings and future generations.

“Knowledge is power,” said Dr. John D’Orazio, chief of the Division of Hematology and Oncology at UK Golisano Children’s. “Just having one of these syndromes does not guarantee that you'll ever get cancer.”

Instead, D’Orazio says identifying an inherited cancer predisposition can allow a patient’s care team to develop a personalized surveillance plan based on the cancers associated with a particular genetic variant, with the goal of identifying disease as early as possible.

Project Inherited Cancer Risk grew from a need D’Orazio saw while caring for children whose family members had been identified with inherited cancer risks through genetic testing. As the program developed, the team recognized that relying on family history and other clinical signs alone could miss patients who carry cancer-related genetic variants.

Every pediatric cancer patient at UK Golisano Children’s is now offered testing through the project.

Dr. Amanda Harrington, medical director of the Pediatric, Adolescent and Young Adult Inherited Cancer Predisposition Service, works with families after an inherited risk has been identified to help them understand what the finding means and develop an individualized approach to screening and surveillance.

For families, she says, receiving that information can bring complicated emotions, including anxiety, but it can also give patients greater ability to make informed decisions about their health.

“It doesn't mean I'm definitely going to get this and the future is still unknown, but I have the choice of whether or not I want to participate in screening upfront and how I want to take care of my own health,” Harrington said.

Genetic counselors are an important part of that process. James Collard, a genetic counselor in the DanceBlue Pediatric Hematology and Oncology Clinic, helps patients and families understand testing options and results, assess risk based on personal and family histories and process the emotional implications that can accompany genetic information.

The program has also grown beyond UK. With support from philanthropic partners and the Kentucky Pediatric Cancer Research Trust Fund, Project Inherited Cancer Risk expanded to Norton Children’s Hospital in Louisville, making testing available through the two institutions that primarily treat children with cancer in Kentucky.

Following UK’s entry into the Golisano Children’s Alliance, D’Orazio and his colleagues have also begun working with other children’s hospitals in the network, including participation in a multidisciplinary germline molecular tumor board that brings experts together to review inherited cancer predisposition cases.

During Childhood Cancer Awareness Month, this episode of “Behind the Blue” explores how genetic testing is changing what clinicians and families can know about cancer risk — and how that knowledge can inform treatment, screening and care for patients and their relatives.

D’Orazio, Harrington and Collard also discuss the emotional impact of living with an inherited cancer risk and the team’s ongoing work to develop educational and psychosocial resources based on feedback directly from patients and families.

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This interview has been edited for time and clarity.