Lynch Syndrome Better ID'd With Universal Screening
(HealthDay News) – A universal screening approach for all newly diagnosed colorectal cancer (CRC) patients improves identification of Lynch syndrome, according to a study published online Feb. 11 in the Journal of Clinical Oncology.
Brandie Heald, from the Cleveland Clinic, and colleagues compared screening approaches for CRC specimens. In approach 1 (January 2004–July 2007), microsatellite instability (MSI)/immunohistochemistry (IHC) results went only to the colorectal surgeon. In approach 2 (August 2007–June 2008), colorectal surgeons and a genetic counselor received the MSI/IHC results and the counselor e-mailed the colorectal surgeon regarding appropriate patients for genetic counseling (GC) referral. In approach 3 (after July 2008), both received MSI/IHC results but the counselor contacted the patient to facilitate referral.
The researchers observed abnormal MSI/IHC results in 178 (16%) of 1,108 patients. In approach 1, 55% of 38 patients with abnormal MSI/IHC were referred for GC, 32% underwent GC, and 26% underwent genetic testing (GT). In approach 2, 82% of 11 patients were referred for GC, 64% underwent GC, and 45% underwent GT. One hundred percent of 56 patients were referred for GC, 71% underwent GC, and 66% underwent GT in approach 3. Comparing approach 3 to approach 1, time from referral to GC was 10-fold quicker.
"Implementation of universal MSI/IHC with GC/GT, along with effective multidisciplinary communication and plans of responsibility for patient contact, resulted in increased identification of patients with Lynch syndrome," the authors write.