Certification Guide

How to become certified in Cancer Genetic Risk Assessment through the National Consortium of Breast Centers’ (NCBC) Cancer Genetic Risk Assessment certification program.

Interested participants contact the National Consortium of Breast Centers office by phone, or email or visit https://www.cgracertification.org/certification-application/and fill out the application. Once the participant is deemed eligible to test and has submitted the required application and fees, a policy guide and list of reference material is sent to their listed email address at least three weeks prior to the testing. Tests are held multiple times per year: in March at the annual NCBC conference and at least twice a year online please visit https://www.navigatorcertifications.org/certification-schedule/ for a schedule of open windows.

Criteria for the application to test are listed below.  Each exam is either 120 questions and you are given 3 hours to take the exam.  Scores are sent via email within 3 weeks of taking the exam.  If an individual does not pass the examination he/she may sit for the examination again during the next 12 months for no additional fee (except travel to where the exam is being offered).  If an applicant desires to sit for the examination again after 12 months of their first registration (or examination) they will need to pay the registration fee again to take the examination.  If the tester fails a second time, they must wait 6 months to retest and must pay a retest fee of $495.

Accreditations for CGRA Exam

On July 4, 2023, the National Commission for Certifying Agencies (NCCA) granted accreditation to the National Consortium of Breast Centers (NCBC) for demonstrating compliance with the NCCA Standards for the Accreditation of Certification Programs. NCCA is the accrediting body of the Institute for Credentialing Excellence. The NCCA Standards were created in 1977 and updated in 2016 to ensure certification programs adhere to modern standards of practice for the certification industry.  The National Consortium of Breast Centers joins an elite group of more than 130 organizations representing over 315 programs that have received and maintained NCCA accreditation. Click here for the official press release


Certification Eligibility: The applicant must:

In order for an individual to be eligible to apply to take the Cancer Genetics Risk Assessment (CGRA) Certification Exam and to receive certification eligibility notification, a candidate must meet all of the following requirements:

Licensure Comply with all state requirements for current and unrestricted licensure as a registered healthcare professional - physician, registered nurse, advanced practice nurse, physician assistant.
Education Complete a minimum of 60 hours of relevant education, training activities in cancer genetics and cancer risk assessment
Experience Complete minimum of two years of clinical practice experience in the field of cancer genetics, cancer risk assessment.
Register Pay the testing fee of $495 and register at www.Breastcare.org
Exam Pass the CGRA exam.

Click this link to obtain the application for Cancer Genetic Risk Assessment (CRGA) Certification: Application for Cancer Genetic Risk Assessment Certification

Eligibility Requirement Rationale
The primary purpose of NCBC in providing a Certification Program in CGRA is to seek to ensure that the healthcare providers (physician, nurse, advanced practice nurse, physician assistant) providing cancer genetic and risk assessment care have the necessary knowledge and skills to practice safely and effectively. NCBC has designed objective criteria intended to determine whether an individual holding NCBC issued certification in CGRA is properly licensed, has attested to focused education and experience in the practice of cancer genetics, cancer risk assessment and has participated in continuing education and other activities sufficient to keep current with advances.

  1. Licensure: The healthcare professional must hold a valid unrestricted state licensure which provides the legal credential and defines scope of practice of the licensed professional – physician, nurse, advanced practice nurse, physician assistant. Voluntary certification indicates compliance with the professional standards for practice in this clinical specialty of cancer genetics and risk assessment.
  2. Experience: Minimum of 2 years of clinical experience in cancer genetics and cancer risk assessment is expected in order for the provider to acquire the necessary knowledge and skills needed to meet or exceed standards for practice in this complex clinical specialty.
  3. Education: Multiple pathways and educational resources are accepted because there is no formalized training or curriculum for the role. 60 hours of continuing education or related training from self-study, practice-based education, online courses, web-based study, review of professional journals, or in-person courses directly related to breast cancer genetics and cancer risk assessment. Tumor board participation provides in-depth, hands-on training in best practices and standards of care for medical treatment with the multi-disciplinary treatment team.

Education and Experience
NCBC conducts the certification program independently of any specific class, course or other education/training program and is also independent of any provider of classes, course or programs. The assessment is not designed to evaluate mastery of the intended learning outcomes of a specific class, course or program, nor is NCBC, as the certification program provider, the sole provider of any education or training that may be required for certification. NCBC’s certification program is also not responsible for accreditation of educational or training programs or courses of study leading to the certification.

There are multiple pathways and educational resources by which a candidate could acquire the requisite specific areas of knowledge for competency as a healthcare provider in cancer genetics and risk assessment.  Resources may include self-study, practice-based education, online course/web-based study, review of professional journals or in-person courses for healthcare providers in cancer genetics and cancer risk assessment.

NCBC is the testing organization therefore we cannot be the educator.
What this means is we are not allowed to provide the educational material for the examination. NCBC will provide a self study handbook within 7 days of receiving payment for those who are registered for the exam, to assist in the review of the main domains and concepts of the expected knowledge.  We will not share samples of our test as that would be a violation of the standards we are held to. The candidate handbook, sent by NCBC, does not contain all the material the applicant should review to prepare for the examination, but it does list the resources from which questions/answers were validated. To prepare for the examination the applicant may take the practice exam questions offered in the study document and refresh him/herself on missed practice test questions, as well as review information received during their medical professional training. This handbook was not designed to teach you about imaging or oncology, you should already know that if you are working in the field. The use of the handbook is optional. The NCBC Certification Board does not require, endorse, or recognize any exam preparation tool as the best, only, or preferred method. Each candidate should develop their own study plan. Use of the self‐study document does not imply or guarantee successful test outcomes. The NCBC Certification Board does not approve, endorse, review or recommend any specific study guides. The self‐study materials are developed independently from the Certification Board. 

Target Audience
Preferred candidates are professionals licensed in the United States, including physicians, nurse practitioners/advanced practice nurses and physician assistants seeking to demonstrate advanced knowledge in providing cancer genetics and cancer risk assessment subspecialty practice. Genetic counselors do not need to obtain this certification as the competencies are covered by genetic counselor training and maintenance of certification. NCBC recognizes that there may be other licensed or certified skilled practitioners who possess the requisite educational background, work-related knowledge, competency, and clinical experience to be considered eligible to apply for certification in CGRA. Inquiries should be forwarded to the program director and will be assessed on a case-by-case basis by the certification board to assure that eligibility for this certification is met before sitting for the CGRA examination.

Cancer Genetic Risk Assessment Role Description

The Certified CGRA certificant:

  • Collects and documents detailed multigenerational family histories/pedigrees and performs genetic cancer risk assessments
  • Initiates genetic testing and interprets genetic test results, develops, and follows through with plans of care, works collaboratively with members of the multidisciplinary care team and makes appropriate referrals
  • Provides pre- and post-test genetic counseling to patients and families at elevated cancer risk
  • Obtains referrals from other health care providers to evaluate and care for patients and families who are at risk for or who have been identified at genetic risk

Definition of the Healthcare Professional with Certification in CGRA
A healthcare professional who holds certification status in CGRA with NCBC is a licensed health care professional with clinical experience caring for cancer patients, assessing patients at high risk for developing cancer including an in-depth knowledge of breast cancer risk assessment. A newly certified professional has the necessary knowledge and skills in CGRA to safely and effectively educate and counsel individuals about cancer risk. This includes but is not limited to, the ability to identify individuals at sufficient risk to recommend cancer genetic testing, interpret and explain possible outcomes of cancer genetic testing, explain health care management options based on risk factors, and communicate results to patient and their family members who could benefit from cancer risk assessment. The minimally qualified candidate must also recognize when the complexity of a case or rarity of a condition merits collaboration or referral to genetics professional or other qualified healthcare professional.