Revised guidelines for the clinical management of Lynch syndrome (HNPCC): recommendations by a group of European experts -- Vasen et al. -- Gut

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Recommendation

Professionals should be aware of the potential psychosocial problems before and after genetic testing and during follow-up and surveillance visits. People with increased psychological distress should be offered referral to a clinical psychologist. All efforts should be made to make colonoscopies as comfortable as possible by paying full attention to adequate pain control and sedation.

Table 5

Pros and cons of surveillance for gynaecological cancer

Pros	Cons
Identification of precursor lesions of endometrial cancer	Small risk of death
Identification of early stage endometrial cancer (not proved)	Physical burden of surveillance examination especially Pipelle biopsy
	No evidence of efficacy for early stage ovarian cancer detection
	Psychological burden