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


METHODS
Published research and review articles, clinical summaries, and personal experience.


CONCLUSIONS
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.


CONCLUSIONS
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.
Lynch
J
J
Department of Preventive Medicine, Creighton University, School of Medicine, Omaha, NE 68178, USA.
D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000235:genetics* / Q000517:prevention & control*; D018450:Disease Progression; D005817:Genetic Counseling; D005820:Genetic Testing; D006801:Humans; D008967:Molecular Biology; D010375:Pedigree; D010641:Phenotype; D011634:Public Health