Brief Answer:
Details on Lynch syndrome and cancer

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
I certainly understand about your concern about polyps, Lynch syndrome and cancer.

Lynch syndrome is an inherited disorder that increases the risk of many types of cancer, particularly cancers of the colon (large intestine) and rectum, which are collectively referred to as colorectal cancer.

There are many genes variations like MLH1, MSH2, MSH6, PMS2, or EPCAM genes which increase the risk of developing Lynch syndrome. It is important to note that people inherit an increased risk of cancer, not the disease itself. Not all people who inherit mutations in these genes will develop cancer.

It has been seen that 3 to 5 percent of cancers in the US are from Lynch syndrome. This condition can also cause benign polyps in the colon at an early age than in the general population.

The Lynch syndrome is still evolving and diagnosis is based on certain criteria followed internationally. It is given below for your reference.

The classic diagnostic criteria for Lynch syndrome are called the Amsterdam Criteria. Over time, the Amsterdam Criteria have been modified to include the variety of cancers that are seen in Lynch syndrome families. The Modified Amsterdam Criteria, also known as the Amsterdam II Criteria, are listed below:

Three or more relatives with a Lynch syndrome-related cancer;* one relative must be a first-degree relative (parent, brother, sister, or child) of the other two

At least two generations with cancer (such as a parent and child)

One or more cases of cancer diagnosed younger than age 50

Familial adenomatous polyposis (FAP) is ruled out as the cause
*(colorectal cancer, endometrial cancer, small bowel, ureter, or renal pelvis cancer; some people would also consider including ovarian cancer)

However there are slight variations in the above criteria as seen in some patients having the condition.

You may consult a genetic specialist to confirm if you have the condition.

All patients of Lynch syndrome are recommended specific cancer screening tests as below.

General screening guidelines

Colonoscopy every one to two years, beginning between the ages of 20 to 25 (or five years younger than the earliest age at diagnosis in the family, whichever is sooner)

Periodic upper endoscopy screening (this procedure uses a thin, flexible tube with a light inserted into the body to examine a specific region) for stomach or intestinal cancer (especially if a family member has had one of these cancers)

Yearly urine cytology to screen for urinary tract cancer

Screening for women

Yearly pelvic examination, Pap test, transvaginal ultrasound (a test where a small ultrasound probe is inserted for a pelvic examination in order to obtain better imaging of the uterus), endometrial biopsy (an examination on a sample of tissue from the inner lining of the uterus done as part of a pelvic examination), and CA-125 blood test (a test to detect a protein found to be elevated in the blood of some women with ovarian cancer), beginning between the ages of 25 to 30

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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