An Exploration of Nursing Roles in Hereditary Colorectal Cancer- A Narrative Literature Review.

OBJECTIVES Hereditary colorectal cancer (CRC) syndromes, including Lynch syndrome and the adenomatous and hamartomatous polyposis conditions, account for up to 10% of CRC cases. Advances in molecular diagnostics and tumor-based testing have improved identification, yet access to genetic testing and lifelong surveillance remains inconsistent worldwide. This narrative review examines the evolving role of nurses in identifying, managing, and supporting individuals and families affected by hereditary CRC.

METHODS A narrative synthesis of international literature, clinical guidelines, and examples of nurse-led models of care from Europe, the United Kingdom, Canada, the United States, Australia, and other health systems was conducted. Articles were included if they addressed hereditary CRC epidemiology, genomic workforce issues, nursing roles, service delivery, or patient experience. A narrative approach was selected to integrate policy documents, and practice models not suited to systematic review methods.

RESULTS Five themes emerged: previvorship and living with inherited risk, genomics workforce capacity, evolving nursing roles, lifelong surveillance, and genomics education. Across health systems, nurses, particularly advanced nurse practitioners (ANPs), clinical nurse specialists (CNSs), and oncology nurses, play an increasingly significant role in hereditary CRC pathways. Their contributions include family history assessment, mainstreaming genetic testing, surveillance coordination, psychosocial support, and patient navigation. Nurse-led models improve access to testing, reduce diagnostic delays, and enhance surveillance adherence. However, roles remain inconsistent across jurisdictions, and challenges persist, including workforce shortages, variable genomics education, limited funding, and an uneven evidence base across the full spectrum of hereditary CRC syndromes.

CONCLUSIONS Nurses act as coordinators across gastroenterology, surgery, oncology, genetics, and primary care- supporting equitable access and continuity throughout the hereditary CRC care trajectory. Despite their growing impact, nursing roles remain under-recognized in guidelines and under-evaluated in research. Systematic investment in genomics education, structured role development, and nurse-led models is required to deliver consistent, patient-centered hereditary CRC care.

IMPLICATIONS FOR NURSING PRACTICE Embedding genomics in nursing education, strengthening structured roles, and supporting nurse-led services within multidisciplinary frameworks are essential to improving equitable access and outcomes.