Ensuring no patient is lost along the way - a single-centre experience of the clinical genetics referral pathways for Lynch syndrome
© 2023 Association of Coloproctology of Great Britain and Ireland..
Lynch syndrome (LS), caused by heterozygous germline mutation in one of the key mismatch repair (MMR) genes, is the primary cause of inherited colorectal cancer (CRC). LS also increases susceptibility to several other cancers. It is estimated that just 5% of patients with LS are aware of their diagnosis. Therefore, in an attempt to increase the identification of cases within the UK population, the 2017 NICE guidelines recommend offering immunohistochemistry for MMR proteins or microsatellite instability (MSI) testing to all people with CRC when first diagnosed. Following identification of MMR deficiency, eligible patients should be assessed for underlying causes, including potential referral to the genetics service and/or germline LS testing (if appropriate). In our regional centre for CRC, we audited local pathways to identify what proportion of patients are being correctly referred, in line with national guidelines. Reflecting on these results, we highlight our practical concerns by identifying the pitfalls and issues faced with the recommended referral pathway. We also propose possible solutions to improve the efficacy of the system for both referrers and patients. Finally, we discuss the ongoing interventions that national bodies and regional centres are implementing to improve and further streamline this process.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland - 25(2023), 5 vom: 15. Mai, Seite 838-842 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
El-Shakankery, Karim Hussien [VerfasserIn] |
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| Links: |
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| Themen: |
Colorectal cancer |
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| Anmerkungen: |
Date Completed 01.06.2023 Date Revised 01.06.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/codi.16496 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352997648 |
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| 520 | |a © 2023 Association of Coloproctology of Great Britain and Ireland. | ||
| 520 | |a Lynch syndrome (LS), caused by heterozygous germline mutation in one of the key mismatch repair (MMR) genes, is the primary cause of inherited colorectal cancer (CRC). LS also increases susceptibility to several other cancers. It is estimated that just 5% of patients with LS are aware of their diagnosis. Therefore, in an attempt to increase the identification of cases within the UK population, the 2017 NICE guidelines recommend offering immunohistochemistry for MMR proteins or microsatellite instability (MSI) testing to all people with CRC when first diagnosed. Following identification of MMR deficiency, eligible patients should be assessed for underlying causes, including potential referral to the genetics service and/or germline LS testing (if appropriate). In our regional centre for CRC, we audited local pathways to identify what proportion of patients are being correctly referred, in line with national guidelines. Reflecting on these results, we highlight our practical concerns by identifying the pitfalls and issues faced with the recommended referral pathway. We also propose possible solutions to improve the efficacy of the system for both referrers and patients. Finally, we discuss the ongoing interventions that national bodies and regional centres are implementing to improve and further streamline this process | ||
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| 700 | 1 | |a Minicozzi, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Diamantis, Nikolaos |e verfasserin |4 aut | |
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