Is cancer screening effective for individuals with Lynch syndrome?

There is fair evidence, based on observational trials only, to support colorectal cancer screening in individuals with Lynch syndrome, but the optimal age of initiation and optimal frequency of screening is unknown. Insufficient evidence is available to recommend screening for other cancers. (LOE = 2a)

Lindor NM, Petersen GM, Hadley DW, et al. Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome. A systematic review. JAMA 2006;296:1507-17.  [PMID:17003399]

Systematic review

Government

Population-based

Lynch syndrome is an autosomal dominant disorder affecting individuals resulting in an increased risk of early onset colon cancer (hereditary nonpolyposis colorectal cancer) and cancers of the endometrium, ovary, hepatobiliary system, small intestine, kidney, and ureter. These investigators thoroughly searched multiple sources, including PubMed, the Cochrane Database of Systematic Reviews, reference lists, and communication with researchers in the field for English-language articles evaluating the effectiveness of cancer screening. Only prospective and retrospective observational trials were found, showing that individuals undergoing regular screening have a reduced mortality rate compared with control patients not screened. High-quality evidence from randomized trials is not currently available. Overall, the authors believe that the evidence supports recommending screening for colon cancer. There is insufficient evidence, however, to support screening for other types of cancer in individuals with Lynch syndrome. The frequency of colorectal cancer screening, and the optimal age at which to begin it, is unknown.