The largest worldwide population screening for cancer family syndromes was initiated in January 2001 in the West Pomeranian Region of Poland with 1.7 m inhabitants. In the first step in the period January 2001 - May 2002 family doctors and nurses collected questionnaires asking about cancer family history among 1st and 2nd degree relatives from 1,258,401 of 1.5 m individuals (87%) who were insured in the West Pomeranian Regional Health Foundation. Up to now about 1.15 m questionnaires have been evaluated by geneticists/oncologists. According to questionnaire data around 2% of families fulfilled criteria to be suspected for cancer family syndrome. Family members (usually 1-2 representatives per family) from suspected families were invited for detailed examination. After pedigree and clinical examination as well as DNA/RNA analyses, high genetic predisposition to neoplasms was diagnosed in 10,525 families. Diagnosis of the following syndromes was established definitively or with high probability:

  1. 1.

    Hereditary breast/ovarian cancer syndrome - 4121 families including 438 families with diagnosed BRCA1/2 mutation.

  2. 2.

    Familial syndromes of colorectal cancer:

    1. a)

      HNPCC - 568 families including 63 families with diagnosed MSH2/MLH1 mutation,

    2. b)

      FAP - 22 families,

    3. c)

      Late onset colorectal cancer aggregations - 459 families.

  3. 3.

    Other hereditary organ specific syndromes:

    1. a)

      hereditary stomach cancer - 1250 families,

    2. b)

      hereditary renal cancer - 565 families,

    3. c)

      hereditary laryngeal cancer - 206 families,

    4. d)

      hereditary prostate cancer - 170 families,

    5. e)

      NFI - 66 families,

    6. f)

      VHL - 36 families,

    7. g)

      Retinoblastoma - 4 families,

    8. h)

      Peutz Jeghers syndrome - 3 families,

    9. i)

      juvenile polyposis - 2 families.

  4. 4.

    Organ-specific familial aggregations:

    1. a)

      familial lung cancer - 242 families,

    2. b)

      familial leukaemia/lymphoma - 77 families,

    3. c)

      familial liver cancer - 68 families,

    4. d)

      familial cervical cancer - 30 families,

    5. e)

      familial pancreatic cancer - 73 families,

    6. f)

      familial melanoma - 44 families,

    7. g)

      familial bladder - 19 families.

  5. 5.

    Unspecified cancer family aggregations - 3319 families.

Appropriate management has been introduced in all identified families with high predisposition to malignancies.