Genetic testing for cancer predisposition and implications for nursing practice: narrative review.

摘要

AIM: 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. DATA SOURCES: 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. REVIEW 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. CONCLUSION: 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.