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Editor—The rapid increase in understanding of cancer genetics in recent years means that few oncology nurses have sufficient knowledge to address the issues of patients concerned about inherited predisposition to cancer.1-3 While some nursing curricula have recently incorporated cancer genetics, this does not assist the large body of oncology nurses already in practice. The need for an educational programme in cancer genetics was highlighted locally by a focus group of senior level nurses and social workers practising in oncology (unpublished data). All felt inadequately equipped to deal with enquiries regarding family history and cancer risk from patients and staff. Nobody in the focus group was aware of the Australian protocols for referral to familial cancer clinics within their employing organisations and family history was not routinely collected.
The Australian guidelines categorise families according to their level of cancer risk (“high”, “moderate”, or “low”) based on family history and/or the presence of a germline mutation known to predispose to cancer.4 In Australia, multidisciplinary Familial Cancer Centres provide genetic counselling, genetic testing, and risk management advice to those families judged to be at “high risk”.
Those categorised at low or moderate inherited risk of cancer may also benefit from informed counselling but may not meet the criteria for referral to the Familial Cancer Centres. As cancers are common, a significant number of people in the community with a family history of cancer will be in these categories. Many will not have a single gene mutation, but are at somewhat increased risk of developing cancer and require surveillance advice.5-7 The person's perception of this risk may not reflect reality. People at moderate risk for breast cancer often overestimate their level of risk.8-10After receiving counselling and a personal risk estimate, most report feeling less worried and their …