Lynch Syndrome

Question 1

Lynch syndrome is associated with:

Answer 1

uterine CA
colorectal cancer 
ovarian cancer
small bowel CA
transitional cell CA (Ureter/Kidney)

Question 2

Common genes associated with Lynch syndrome are:

Answer 2

MLH1, MSH2, MSH6, and PMS2

Question 3

Screening and Surveillance Recommendations for Women

With Lynch Syndrome

Answer 3

Colonoscopy every 1–2 years, beginning at age 20–25 years, or 2–5 years before the earliest cancer diagnosis in the family, whichever is earlier
Endometrial biopsy every 1–2 years, beginning at age 30–35 years
Keeping a menstrual calendar and evaluating abnormal uterine bleeding

Question 4

What is is a risk-reducing option for women with Lynch syndrome who have completed childbearing?

Answer 4

Prophylactic hysterectomy with BSO

Question 5

How should we be assessing the possibility of Lynch syndrome in a woman personally affected with colorectal or endometrial cancer?

Answer 5

Perform tumor testing on all endometrial or colorectal tumors irrespective of age of diagnosis. Test the tumor for the expression of mismatch repair genes or for microsatellite instability.

Question 6

What are the “Amsterdam Criteria”? (3-2-1)

Answer 6

3 affected family members
2 generations
1 under 50 years old

Question 7

How is Lynch inherited?

Answer 7

Autosomal Dominant

Question 8

What should younger patients take to mitigate risk?

Answer 8

OCPs or progesterone based contraception