Our new study shows that we can do much more to identify patients with Lynch syndrome in the UK. We already know that diagnosing Lynch syndrome can affect the treatment of a patient with bowel cancer – and can save the lives of their family members. Every team dealing with bowel cancer patients needs to routinely discuss the possibility of an inherited cancer syndrome. This study has just been published in the journal ‘Frontline Gastroenterology’.
Lynch syndrome is the most common familial bowel cancer syndrome. European guidelines suggest selective screening of appropriate colorectal cancer patients, according to the revised Bethesda criteria. Many eligible patients do not undergo the necessary investigation.
What this study adds
This is the first time that UK practice in this area has been evaluated. Our patients are assessed haphazardly for Lynch syndrome, and we do not follow international guidance. This will lead to under-diagnosis and missed opportunities to reduce cancer mortality. impact on clinical practice in the foreseeable
Colorectal cancer teams should incorporate a revised Bethesda assessment into the routine discussion of each new patient. They should develop screening and referral pathways with their local genetics services. This aspect of their work can be audited and may become a quality standard in the future.
The “Family History of Bowel Cancer” clinic at the West Middlesex University Hospital, led by Dr Kevin Monahan, helps assess patients with a significant family background of cancers. Patients, GPs and other health professionals can read more about our service, and how to make a referral, at https://familyhistorybowelcancer.wordpress.com.