Lynch Syndrome Better ID'd With Universal Screening
Findings among surgically resected CRC patients in program that actively reports abnormal results
TUESDAY, Feb. 19 (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 to July 2007), microsatellite instability (MSI)/immunohistochemistry (IHC) results went only to the colorectal surgeon. In approach 2 (August 2007 to 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 percent) of 1,108 patients. In approach 1, 55 percent of 38 patients with abnormal MSI/IHC were referred for GC, 32 percent underwent GC, and 26 percent underwent genetic testing (GT). In approach 2, 82 percent of 11 patients were referred for GC, 64 percent underwent GC, and 45 percent underwent GT. One hundred percent of 56 patients were referred for GC, 71 percent underwent GC, and 66 percent 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.