Management of HNPCC (Lynch Syndrome) cancer patients as per Myriad Labs

Please note: there are no standard practice guidelines for the managment of Lynch syndrome patients and the followup of these patients may vary depending on your location/healthcare institution. In addition, family history is still the most important criteria irrespective of a negative test result. Sandi
Following a positive test result, preventive measures such as these can be taken. This type of ongoing surveillance may lead to early detection and intervention which may, in turn, positively impact outcomes for HNPCC patients. Increased Surveillance for Colorectal Cancer Colonoscopy every one to two years beginning at age 20-25 or 5-10 years before the earliest age of a diagnosed colorectal cancer in patient's family, whichever comes first. Colonoscopy annually after age 40.24, 52, 53 Surgical Management for Colorectal Cancer If colon cancer is diagnosed (or if more than one advanced adenoma is found) in a patient with HNPCC, total colectomy with ileorectal anastomosis OR hemicolectomy are the recommended surgical procedures, rather than segmental colectomy.54 In carefully selected patients, (i.e. those not willing or able to undergo periodic screening) prophylactic total colectomy with ileorectal anastomosis may be presented as an option based on carrier status alone.24, 54 Increased Surveillance for Endometrial Cancer Gynecologic exam, transvaginal ultrasound, endometrial aspiration, and CA-125 every one to two years, beginning at age 25-35.24, 52 Surgical Management for Endometrial and Ovarian Cancer Prophylactic total abdominal hysterectomy and bilateral salpingo-oophorectomy may be considered if colorectal cancer is detected and may also be considered as an option when childbearing is concluded (especially if bleeding or other symptoms of uterine or ovarian disease occur).24, 54 Increased Surveillance for Other HNPCC-Related Cancers The following screening may be recommended based on the patient's family history.21, 24 For stomach cancer, gastroscopy every one to two years starting at age 30-35. For urinary tract cancer, ultrasonography or urine cytology every one to two years starting at age 30-35.