Scoping the family history: assessment of Lynch syndrome (hereditary nonpolyposis colorectal cancer) in primary care settings--a primer for nurse practitioners.

摘要: Purpose: To describe and discuss the characteristic features red flags of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, that warrants referral for genetic cancer risk assessment (GCRA). A focus on nurse practitioner’s (NP) role in familial assessment, physical examination, initiationofgeneticreferrals,andissuesrelatedtothegeneticcounselingprocess are discussed. Data sources: review synopsis professional guidelines, clinical articles, research studies syndrome genetics inherited syndromes associated with cancer. Online resources from American Gastroenterological Association, Medical Nurses National Comprehensive Cancer Network, NationalCancerInstitute,theNationalCancerInstitute—PhysicianDataQuery, theNationalCoalitionofHealthProfessionalEducationinGenetics,theNational HumanGenomeResearchInstitute,theNationalSocietyofGeneticCounselors, International Society Genetics, Oncology Nursing Society. Conclusions: Approximately 5% all colon cancers because a germ line mutation predisposing individuals their family members to other cancers. Although efficacy screening modalities is established, healthcare providers often fail identify those at greatest disease. The extended history first step recognition ‘‘suspect’’ hereditarycolon such asLynch syndrome. Early-age onset syndrome‐associated cancers, an autosomal-dominant pattern, multiple primary tumors individual or pathological member ‘‘red flags’’ will aid NPs identifying who may benefit GCRA. Implications practitioner practice: importance enhanced surveillance early diagnosis prevention disease critical part care. Thus, it imperative obtain minimum threegeneration pedigree, recognize patterns, provide counseling consideration testing suspect