A Single Institution Experience in Compliance with Universal Screening for Lynch Syndrome in Colorectal Cancer

Amy L. Hill, Kirandeep K. Sumra, Marcia M. Russell, James Yoo, Clifford Y. Ko, Steven Hart, Zev Wainberg, J. Randolph Hecht, Anne Y. Lin

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Design and Settings: This study is a retrospective analysis of Lynch syndrome screening among colorectal cancer patients undergoing surgery in a single healthcare system.

Patients: Two hundred and sixty-two patients who underwent surgery for colorectal cancer were studied.

Main Outcome Measures: Rate of Lynch syndrome screening.

Limitations: Results may not be generalizable to different hospital settings.

Conclusions: Several potential system-level interventions were identified to improve screening rates including an emphasis on improved provider communication.

Results: We identified that 75 % of the total cohort was screened for Lynch syndrome. Of patients under the age of 50, 78 % percent were screened. Lower screening rates were found among patients with complete pathologic tumor response and lower pathologic stage of tumor. Higher screening rates were found at the academic hospital and with colorectal surgeons. In multivariable logistic regression analysis, lower screening rates were associated with community hospital location (OR, 0.22; 95 % CI, 0.08–0.56).

Background: Detection of Lynch syndrome has the potential to reduce morbidity and mortality among patients and their family members due to beneficial screening and treatment options. Several institutions have begun to adopt universal rather than risk-stratified screening protocols, but the lack of 100 % compliance rates requires identification of system-level interventions to improve screening practices.

Objective: We aimed to identify patient, tumor, and system factors associated with lack of screening and identify system-based interventions to improve Lynch syndrome screening.

Original languageEnglish (US)
Pages (from-to)543-550
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume19
Issue number3
DOIs
StatePublished - 2015

Keywords

  • Immunohistochemistry
  • Lynch syndrome
  • Microsatellite instability
  • Universal screening

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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    Hill, A. L., Sumra, K. K., Russell, M. M., Yoo, J., Ko, C. Y., Hart, S., Wainberg, Z., Hecht, J. R., & Lin, A. Y. (2015). A Single Institution Experience in Compliance with Universal Screening for Lynch Syndrome in Colorectal Cancer. Journal of Gastrointestinal Surgery, 19(3), 543-550. https://doi.org/10.1007/s11605-014-2687-x