Lynch syndrome poses multiple cancer risks, yet attention has focused on screening for colorectal cancer.
Estimated risks for endometrial cancer equal risks for colorectal cancer.
Dr Donald Hadley and colleagues from Maryland, USA evaluated women's perceived risks for cancers, and compared endometrial cancer screening and colonoscopy.
In addition, the research team identified predictors of screening before and after genetic testing.
|Carriers demonstrated an increase in their perceived risk for extracolonic cancers|
|Journal of Clinical Oncology|
The team identified 65 adult women at 50% risk for carrying a cancer-predisposing mutation, without a history of endometrial cancer or hysterectomy.
The women participated in genetic counseling and received unequivocal genetic test results for Lynch syndrome.
Participants completed questionnaires before and after receipt of genetic results.
Pretest, perceived risks for colon cancer were significantly higher than for extracolonic cancers.
The team found use of colonoscopy was significantly higher than endometrial cancer screening.
Post-test, carriers demonstrated an increase in their perceived risk for extracolonic cancers and increased both colonoscopy and endometrial cancer screening.
Mutation status, age, perceived likelihood of carrying a mutation, and communication of test results to their physician independently predicted cancer screening at follow-up.
Dr Hadley's team concluded, "Women in families with Lynch syndrome are less aware of their risks for extracolonic cancers and undergo endometrial cancer screening significantly less often than colonoscopy before genetic counseling."
"Given the significantly increased risks for endometrial and ovarian cancers and the mortality associated with ovarian cancer, additional efforts to inform families of cancer risks and screening recommendations seem prudent."
"Physicians play a critical role in ensuring appropriate cancer screening in women with Lynch syndrome."