In approximately 25% of all breast, ovarian, and colon cancers, there is a familial accumulation. In around 10%, mutations in high-risk genes (BRCA1, BRCA2, RAD51C, MLH1, and MSH2) can be detected, which are associated with a risk of illness of about 80%. In the remaining families, lowpenetrance gene variants,which are associated with a moderate risk, appear to be the underlying cause according to the current state of knowledge.

In the national consortia for familial breast/ovarian cancer and colorectal cancer, prospective data on intensified early detection and prophylactic surgeries have been collected over the past 15 years from approximately 14,000 families with breast and ovarian cancer and approximately 8,000 families with colorectal cancer and stored in a central database.

Based on these cohorts, the planned project aims to:

1. Conduct a risk-stratified cost-benefit assessment of risk-adjusted early detection using a Markov model,
2. Develop a regulatory proposal for the provision of preventive measures, taking into account medical findings, the principle of economic efficiency, and constitutional requirements,
3. Create a matrix of ethical and legal criteria to be considered,
4. Design a structured catalogue of advisory content for risk communication as the basis for an informed decision-making.
5.  

The results will be discussed with stakeholders in the healthcare system and integrated into the care concepts of the consortia.