OBJECTIVE To provide a comprehensive overview of the role of the oncology nurse in cancer risk assessment and counseling. METHODS Review articles, research studies, and book chapters. CONCLUSIONS New genetic discoveries are changing how risk for some cancers is being determined and managed. Cancer risk counseling and genetic testing are emerging components of clinical care. CONCLUSIONS Oncology nurses will have an increasingly important role in casefinding, risk assessment, education, counseling, psychosocial support, health advocacy, and the coordination of services and referrals for cancer risk management. In addition, nurses can conduct research on the effects of these new genetic applications on individuals and families, and educate others about the implications of this evolving field.