Review of the Lynch syndrome: History, molecular genetics, screening, differential diagnosis, and medicolegal ramifications

Henry T. Lynch, P. M. Lynch, Stephen J. Lanspa, C. L. Snyder, J. F. Lynch, C. R. Boland

Research output: Contribution to journalReview article

476 Citations (Scopus)

Abstract

More than one million patients will manifest colorectal cancer (CRC) this year of which, conservatively, approximately 3% (∼30,700 cases) will have Lynch syndrome (LS), the most common hereditary CRC predisposing syndrome. Each case belongs to a family with clinical needs that require genetic counseling, DNA testing for mismatch repair genes (most frequently MLH1 or MSH2) and screening for CRC. Colonoscopy is mandated, given CRC's proximal occurrence (70-80% proximal to the splenic flexure). Due to its early age of onset (average 45 years of age), colonoscopy needs to start by age 25, and because of its accelerated carcinogenesis, it should be repeated every 1 to 2 years through age 40 and then annually thereafter. Should CRC occur, subtotal colectomy may be necessary, given the marked frequency of synchronous and metachronous CRC. Because 40-60% of female patients will manifest endometrial cancer, tailored management is essential. Additional extracolonic cancers include ovary, stomach, small bowel, pancreas, hepatobiliary tract, upper uroepithelial tract, brain (Turcot variant) and sebaceous adenomas/carcinomas (Muir-Torre variant). LS explains only 10-25% of familial CRC.

Original languageEnglish
Pages (from-to)1-18
Number of pages18
JournalClinical Genetics
Volume76
Issue number1
DOIs
StatePublished - 2009

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Hereditary Nonpolyposis Colorectal Neoplasms
Genetic Testing
Molecular Biology
Colorectal Neoplasms
Differential Diagnosis
History
Colonoscopy
Transverse Colon
DNA Mismatch Repair
Colectomy
Genetic Counseling
Endometrial Neoplasms
Age of Onset
Adenoma
Ovarian Neoplasms
Pancreas
Stomach
Carcinogenesis
Carcinoma
Brain

All Science Journal Classification (ASJC) codes

  • Genetics(clinical)
  • Genetics

Cite this

Review of the Lynch syndrome : History, molecular genetics, screening, differential diagnosis, and medicolegal ramifications. / Lynch, Henry T.; Lynch, P. M.; Lanspa, Stephen J.; Snyder, C. L.; Lynch, J. F.; Boland, C. R.

In: Clinical Genetics, Vol. 76, No. 1, 2009, p. 1-18.

Research output: Contribution to journalReview article

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