Pit Fall of First Screening of Lynch Syndrome from Medical Records

Abstract

We performed first screening of Lynch syndrome (LS) using Amsterdam criteria Ⅱ (ACⅡ) and Revised Bethesda guidelines (rBG) from medical records, including 893 colorectal cancer patients who underwent colectomy in our institute, and analyzed the usefulness and problems for ACⅡ and rBG . The most frequent cancer related to LS was gastric cancer (23 cases) except colorectal cancer in a proband and first- or second-degree relatives. Of 893 patients, 146 patients were determined as candidates of LS by rBG, while no patients were satisfied with all the subjects of ACⅡ. The age at diagnosis of cancer in almost first- or second-degree relatives was missed in medical charts. If we know that correctly, the number of candidates of LS using ACⅡ and rBG as first screening increase up to ３ patients (0.3％) and 87 patients (9.8％), respectively. In conclusion, we recommend rBG for first screening to detect candidates of LS in clinical practice, keeping in mind that hearing the age at diagnosis of cancer in first-degree relatives is essential.