Genetic testing for cancer predisposition and implications for nursing practice: narrative review.
OBJECTIVE
This paper is a report of a review of literature on the psychological and social implications of genetic testing for cancer predisposition and how recent developments in knowledge about genetics may affect clinical practice.


BACKGROUND
Knowledge about the genetics of disease has grown since the completion of the Human Genome Project. Many common genetic changes that predispose to cancer have been found. Identifying genetically 'at risk' individuals is going to become a feature of healthcare and nursing practice over the next decade. The psychological and social effects of this knowledge on patients and their families are important considerations.


METHODS
A search of the British Nursing Index, CINAHL, EMBASE and PUBMED databases was conducted between June 2007 and December 2008 without date limits. Grey literature was sought using search engines and through searching relevant websites.


METHODS
A narrative review of studies published in English was conducted. The studies were reviewed for relevance and inclusion criteria; their methodological quality was not evaluated.


RESULTS
Seventy-eight papers met the inclusion criteria and fell into three thematic categories: social impact, psychological impact and interest in and uptake of genetic testing. To date, research has focussed on high-risk cancer genes.


CONCLUSIONS
Genetic testing raises social, ethical and psychological concerns. Further research is required to determine how healthcare professionals can support the integration of genetics into clinical practice. Nurses will become increasingly involved in genetic testing and will play a key role in providing information, support and follow-up for individuals identified as being at higher risk.
Bancroft
Elizabeth Kathryn
EK
Royal Marsden NHS Foundation Trust & Institute of Cancer Research, Sutton, Surrey, UK. elizabeth.bancroft@rmh.nhs.uk
D001294:Attitude to Health; D005817:Genetic Counseling / Q000523:psychology; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000235:genetics*; D009736:Nursing Process