2017 UPDATE OF UK LYNCH SYNDROME SCREENING GUIDELINES
EUROPEAN GUIDELINES BY THE MALLORCA GROUP 2013.


Read the full paper at Vasen HFA in “revised guidelines for the clinical management of Lynch syndrome (HNPCC) recommendations by a group of European experts” in Gut 2013


http://dx.doi.org/10.1136/gutjnl-2012-304356

Large bowel (colon and rectum)

When – from age 25 years (sometimes needs to be younger)
Who – all LS gene mutation carriers
How – colonoscopy
How frequent – every 1-2 year
s

Uterus and ovaries
When – from age 35 – 40 years
Who – all LS gene mutation carriers
How – risk-reducing surgery (RRS) by hysterectomy and removal of both ovaries is the safest way to cut risk
However– some gynaecologists offer screening but the safety of this has not been proved (that is cancers not found). That involves annual examination, endometrial biopsy and TVUS (transvaginal ultrasound scan) and serum CA125 at least annually.

Stomach
When – from age 30-35 years
Who – only those people with LS who live in a country with a high incidence of gastric cancer
How – gastric endoscopy
How frequent – every 1-2 years
But – every person with Lynch syndrome should have HP testing – treatment – retest when they are diagnosed. Helicobacter pylori is a bacteria that aggravates the stomach lining.

Urinary tract (kidney, ureter, bladder)
When - from age 30-35 years
Who -MSH2 and Epcam gene mutation carriers only
How – screening by urine cytology and abdominal ultrasound (some urologists do cystoscopy)
How often – every year

Discuss all your screening options with your genetic counsellor. Screening does differ locally and family and personal cancer history may alter your requirements. Please note that individual gene mutations /alterations have different risks. This table is just a summary.

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