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@article{Cavazza:2019:10.1111/codi.14597,
author = {Cavazza, A and Chandni, R and Chris, H and Monahan, K},
doi = {10.1111/codi.14597},
journal = {Colorectal Disease},
title = {An experience of implementation and outcomes of universal testing for Lynch Syndrome in the United Kingdom},
url = {http://dx.doi.org/10.1111/codi.14597},
volume = {21},
year = {2019}
}

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TY  - JOUR
AB  - AimColorectal cancer (CRC) is diagnosed in approximately 45 000 people annually in the UK, and it is estimated that Lynch syndrome (LS) accounts for 3.1% of these cases. In February 2017, National Institute for Health and Care Excellence (NICE guideline DG27 recommended universal testing of new cases of CRC for mismatch repair (MMR) status. The aim of this study was to implement universal testing for LS in CRC patients in a secondary care setting.MethodWe prospectively collected data on consecutive newly diagnosed CRC patients at our centre from November 2016 to August 2018, including evidence of MMR status determined by immunohistochemistry. We recorded clinicopathological data including age at diagnosis, stage, tumour site, reported histological findings and MMR tumour status. Statistical analysis was performed using the chisquare test and the twotailed ttest for binary and continuous variables, respectively.ResultsA cohort of 203 consecutive patients were diagnosed with CRC during this period. Universal MMR testing was performed for the 198 CRC patients in whom a diagnosis of adenocarcinoma was confirmed, with colonoscopic biopsy used as the source material in 68.6% of cases. Twentythree CRCs (11.6%) were MMR deficient (dMMR). Most dMMR CRCs (21/23) were early stage tumours (Dukes A or B, P = 0.002). In 39 Dukes B CRCs in patients under 70 years of age, the result of MMR testing influenced decisionmaking about personalized treatment with 5fluorouracil based chemotherapy.ConclusionOur results demonstrate that universal testing of all new cases of CRC for features suggestive of LS is feasible and effective in the UK. Our data also indicate the importance of genetic testing and personalized oncological care.
AU  - Cavazza,A
AU  - Chandni,R
AU  - Chris,H
AU  - Monahan,K
DO  - 10.1111/codi.14597
PY  - 2019///
SN  - 1462-8910
TI  - An experience of implementation and outcomes of universal testing for Lynch Syndrome in the United Kingdom
T2  - Colorectal Disease
UR  - http://dx.doi.org/10.1111/codi.14597
UR  - http://hdl.handle.net/10044/1/68180
VL  - 21
ER  -

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