Keith Warner had colon cancer in 1969 when he was 34. Three months later, his sister died of the disease, which his mother had already suffered. Warner suffered a second cancer in 1994, and one of his daughters was diagnosed in 1996 (shortly after giving birth to her first child) with a non-functioning islet cell cancer. She died in 1998.

With cancer all around his family, Warner didn't perceive the genetic connection until he attended an American Cancer Society meeting and someone mentioned the possibility of Lynch syndrome. Parents with the syndrome, he learned, have a 50-50 chance of passing a genetic variant to their children that increases their risk for early colon cancer and other cancers.

"The gong went off in my head,"Warner recalled. "It was right in front of me, but I didn't see it. Obviously, we had a lot going on."

Since that time, Warner, 76, of Vadnais Heights, has become a strong public advocate via the American Cancer Society for genetic testing – especially for any families with cancer histories. But as Warner's own family story shows, the idea of genetic testing is not as easy as it sounds.

Despite his persistence, some members of his extended family won't seek the genetic testing or recommend it for their own children. This is a familiar issue for genetic counselors, who encounter people who should be tested but are too fearful of the results and the impact they could have on their lives. Fears include discrimination by potential employers and health insurers. Disclosing genetic test results could complicate relationships with potential spouses as well. It is incomprehensible to Warner that people wouldn't want to know. Most of his relatives already know they have a 50-50 chance of having the genetic variant, so he believes testing could be a source of relief for some of them.

"The only way you can put out a fire is run to it," said Warner, reflecting on his days with a fire crew in the Air National Guard. "You have to run to the problem to solve it."

Warner's four surviving children have been tested, and three of them have the genetic variant that increases the risk of early colon, ovarian, uterine and other cancers. His youngest daughter took the proactive steps of annual colonoscopies – which routinely found polyps – and of having a hysterectomy after she gave birth to her two children. Warner said at least one relative in his extended family hasn't even told his children about the potential for the genetic variant. He said he has sent information about the family's health history and Lynch Syndrome to all of his nieces and nephews.

The cancer-related death of his daughter, Lori, still weighs on him. She dreamed of staying alive to take her daughter to her first day of kindergarten, but died before that event. In their final conversation together, Warner told his daughter that he would commit his time and energy to helping people cope with cancer and raising money for research. He organized White Bear Lake's first Relay for Life walking event, and over the past decades that annual event has raised more than $3 million.

Warner said he understands the guilt of being a parent who hands down a troubling genetic trait. But it is far from the only thing he has passed down to his kids. His advocacy for testing has also given them an early warning and an opportunity to prevent cancer or detect it at its most treatable stage.

"I think I've dealt well with what some people would call guilt," he said. "I total understand that I can't do anything to change my genetic makeup. If it's there, it's there."