The genetics and natural history of hereditary colon cancer.

OBJECTIVES

To provide an overview of the genetics, natural history, surveillance and management of hereditary colorectal cancer with emphasis on hereditary nonpolyposis colorectal cancer (HNPCC).

DATA SOURCES: Published research and review articles, clinical summaries, and personal experience.

CONCLUSION

Hereditary factors may account for approximately 10% of colorectal cancer cases. Genes responsible for some of these disorders have been identified and cloned, making it possible to test family members for gene carrier status. Identification of individuals at highest risk for cancer could lead to more effective prevention and early detection. However, there are potential medical, psychological, and insurance problems inherent in predisposition testing that must be addressed.

IMPLICATIONS FOR NURSING PRACTICE: Nurses can play a key role in identifying patients who may be at high risk for colorectal cancer by recognizing a significant cancer family history. A well-informed nurse can assist in counseling the patient so that he/she can be knowledgeable about all aspects of genetic testing. When a cancer genetic diagnostic has been established, nurses can be emotionally supportive and reinforce the importance for continued surveillance or prophylactic surgery.