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Lynch syndrome: the patients perspective

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Abstract

People with Lynch syndrome have a high lifetime risk for the development of colorectal, endometrial and several other types of cancer. Lynch syndrome is caused by germline mutations in genes encoding DNA mismatch repair proteins. In this review, issues that concern Lynch patients are highlighted from the patients’ perspective. Both authors are affected by Lynch syndrome and are active in Lynch patient organizations. The goal of this review is to assist heath care providers in the improvement of care for individuals who share our disorder. Institutional and/or national guidelines that should lead to the identification of Lynch patients have been developed in many countries. However, adherence to these guidelines is poor and the consequence is severe underdiagnosis of Lynch syndrome. An important task of patient organizations is therefore to increase awareness of Lynch syndrome among the general public and health care providers. Because diagnosis of Lynch syndrome based on family history is difficult, the use of molecular and or histological techniques that permit unequivocal diagnosis should be more aggressively promoted. Since Lynch syndrome encompasses a broad spectrum of cancers, a multidisciplinary treatment and screening protocol for all Lynch patients is necessary. Lynch patients must be seen by a team of specialists that are knowledgeable in the various manifestations of Lynch syndrome. Because tumors with mismatch repair deficiency have specific properties, identification of effective chemotherapy regimens, specifically targeted to patients with deficiencies in DNA repair mechanisms, must be developed. The high lifetime risk of developing cancer in Lynch patients warrants lifestyle advice and research into chemopreventive measures that reduce the risk of cancer in this vulnerable group. Implementation of these recommendations will result in greatly improved quality of life for people affected with Lynch syndrome, it is therefore important that health care providers and patient organizations work together to achieve these goals.

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References

  1. Lynch HT, Lynch PM, Lanspa SJ, Snyder CL, Lynch JF, Boland CR (2009) Review of the Lynch syndrome: history, molecular genetics, screening, differential diagnosis, and medicolegal ramifications. Clin Genet 76:1–18

    Article  PubMed  CAS  Google Scholar 

  2. Bonadona V, Bonaiti B, Olschwang S, Grandjouan S, Huiart L, Longy M, Guimbaud R, Buecher B, Bignon YJ, Caron O, Colas C, Nogues C, Lejeune-Dumoulin S, Olivier-Faivre L, Polycarpe-Osaer F, Nguyen TD, Desseigne F, Saurin JC, Berthet P, Leroux D, Duffour J, Manouvrier S, Frebourg T, Sobol H, Lasset C, Bonaiti-Pellie C (2011) Cancer risks associated with germline mutations in MLH1, MSH2, and MSH6 genes in Lynch syndrome. JAMA 305:2304–2310

    Article  PubMed  CAS  Google Scholar 

  3. Poulogiannis G, Frayling IM, Arends MJ (2010) DNA mismatch repair deficiency in sporadic colorectal cancer and Lynch syndrome. Histopathology 56:167–179

    Article  PubMed  Google Scholar 

  4. Vasen HF, Abdirahman M, Brohet R, Langers AM, Kleibeuker JH, Kouwen M, Koornstra JJ, Boot H, Cats A, Dekker E, Sanduleanu S, Poley JW, Hardwick JC, Vos Tot Nederveen Cappel WH, van der Meulen-de Jong AE, Tan TG, Jacobs MA, Mohamed FL, de Boer SY, van de Meeberg PC, Verhulst ML, Salemans JM, van, Bentem N, Westerveld BD, Vecht J, Nagengast FM (2010) One to 2-year surveillance intervals reduce risk of colorectal cancer in families with Lynch syndrome Gastroenterology 138: 2300–2306

  5. de Jong AE, Hendriks YM, Kleibeuker JH, de Boer SY, Cats A, Griffioen G, Nagengast FM, Nelis FG, Rookus MA, Vasen HF (2006) Decrease in mortality in Lynch syndrome families because of surveillance. Gastroenterology 130:665–671

    Article  PubMed  Google Scholar 

  6. Hampel H, de la Chapelle A (2011) The search for unaffected individuals with Lynch syndrome: do the ends justify the means? Cancer Prev Res (Phila) 4:1–5

    Article  Google Scholar 

  7. Lindor NM, Petersen GM, Hadley DW, Kinney AY, Miesfeldt S, Lu KH, Lynch P, Burke W, Press N (2006) Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review. JAMA 296:1507–1517

    Article  PubMed  CAS  Google Scholar 

  8. Hampel H, Frankel WL, Martin E, Arnold M, Khanduja K, Kuebler P, Nakagawa H, Sotamaa K, Prior TW, Westman J, Panescu J, Fix D, Lockman J, Comeras I, de la Chapelle A (2005) Screening for the Lynch syndrome (hereditary nonpolyposis colorectal cancer). N Engl J Med 352:1851–1860

    Article  PubMed  CAS  Google Scholar 

  9. Singh H, Schiesser R, Anand G, Richardson PA, El-Serag HB (2010) Underdiagnosis of Lynch syndrome involves more than family history criteria. Clin Gastroenterol Hepatol 8:523–529

    Article  PubMed  Google Scholar 

  10. Wang G, Kuppermann M, Kim B, Phillips KA, Ladabaum U (2012) Influence of patient preferences on the cost-effectiveness of screening for lynch syndrome. J Oncol Pract 8:e24s–e30s

    Article  PubMed  Google Scholar 

  11. Dinh TA, Rosner BI, Atwood JC, Boland CR, Syngal S, Vasen HF, Gruber SB, Burt RW (2011) Health benefits and cost-effectiveness of primary genetic screening for Lynch syndrome in the general population. Cancer Prev Res (Phila) 4:9–22

    Article  Google Scholar 

  12. Ladabaum U, Wang G, Terdiman J, Blanco A, Kuppermann M, Boland CR, Ford J, Elkin E, Phillips KA (2011) Strategies to identify the Lynch syndrome among patients with colorectal cancer: a cost-effectiveness analysis. Ann Intern Med 155:69–79

    Article  PubMed  Google Scholar 

  13. Vasen HF, Moslein G, Alonso A, Aretz S, Bernstein I, Bertario L, Blanco I, Bulow S, Burn J, Capella G, Colas C, Engel C, Frayling I, Rahner N, Hes FJ, Hodgson S, Mecklin JP, Moller P, Myrhoj T, Nagengast FM, Parc Y, Ponz de Leon M, Renkonen-Sinisalo L, Sampson JR, Stormorken A, Tejpar S, Thomas HJ, Wijnen J, Lubinski J, Jarvinen H, Claes E, Heinimann K, Karagiannis JA, Lindblom A, Dove-Edwin I, Muller H (2010) Recommendations to improve identification of hereditary and familial colorectal cancer in Europe. Fam Cancer 9:109–115

    Article  PubMed  CAS  Google Scholar 

  14. Bonnet D, Selves J, Toulas C, Danjoux M, Duffas JP, Portier G, Kirzin S, Ghouti L, Carrere N, Suc B, Alric L, Barange K, Buscail L, Chaubard T, Imani K, Guimbaud R (2012) Simplified identification of Lynch syndrome: a prospective, multicenter study. Dig Liver Dis 44:515–522

    Article  PubMed  Google Scholar 

  15. Auranen A, Joutsiniemi T (2011) A systematic review of gynecological cancer surveillance in women belonging to hereditary nonpolyposis colorectal cancer (Lynch syndrome) families. Acta Obstet Gynecol Scand 90:437–444

    Article  PubMed  Google Scholar 

  16. Sargent DJ, Marsoni S, Monges G, Thibodeau SN, Labianca R, Hamilton SR, French AJ, Kabat B, Foster NR, Torri V, Ribic C, Grothey A, Moore M, Zaniboni A, Seitz JF, Sinicrope F, Gallinger S (2010) Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer. J Clin Oncol 28:3219–3226

    Article  PubMed  CAS  Google Scholar 

  17. Dorard C, de Thonel A, Collura A, Marisa L, Svrcek M, Lagrange A, Jego G, Wanherdrick K, Joly AL, Buhard O, Gobbo J, Penard-Lacronique V, Zouali H, Tubacher E, Kirzin S, Selves J, Milano G, Etienne-Grimaldi MC, Bengrine-Lefevre L, Louvet C, Tournigand C, Lefevre JH, Parc Y, Tiret E, Flejou JF, Gaub MP, Garrido C, Duval A (2011) Expression of a mutant HSP110 sensitizes colorectal cancer cells to chemotherapy and improves disease prognosis. Nat Med 17:1283–1289

    Article  PubMed  CAS  Google Scholar 

  18. Kolonel LN, Altshuler D, Henderson BE (2004) The multiethnic cohort study: exploring genes, lifestyle and cancer risk. Nat Rev Cancer 4:519–527

    Article  PubMed  CAS  Google Scholar 

  19. Diergaarde B, Braam H, Vasen HF, Nagengast FM, van Muijen GN, Kok FJ, Kampman E (2007) Environmental factors and colorectal tumor risk in individuals with hereditary nonpolyposis colorectal cancer. Clin Gastroenterol Hepatol 5:736–742

    Article  PubMed  Google Scholar 

  20. Botma A, Nagengast FM, Braem MG, Hendriks JC, Kleibeuker JH, Vasen HF, Kampman E (2010) Body mass index increases risk of colorectal adenomas in men with Lynch syndrome: the GEOLynch cohort study. J Clin Oncol 28:4346–4353

    Article  PubMed  Google Scholar 

  21. Burn J, Gerdes AM, Macrae F, Mecklin JP, Moeslein G, Olschwang S, Eccles D, Evans DG, Maher ER, Bertario L, Bisgaard ML, Dunlop MG, Ho JW, Hodgson SV, Lindblom A, Lubinski J, Morrison PJ, Murday V, Ramesar R, Side L, Scott RJ, Thomas HJ, Vasen HF, Barker G, Crawford G, Elliott F, Movahedi M, Pylvanainen K, Wijnen JT, Fodde R, Lynch HT, Mathers JC, Bishop DT (2011) Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 randomised controlled trial. Lancet 378:2081–2087

    Article  PubMed  Google Scholar 

  22. Mueck AO, Seeger H, Rabe T (2010) Hormonal contraception and risk of endometrial cancer: a systematic review. Endocr Relat Cancer 17:R263–R271

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Jurgen Seppen.

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Seppen, J., Bruzzone, L. Lynch syndrome: the patients perspective. Familial Cancer 12, 341–345 (2013). https://doi.org/10.1007/s10689-013-9630-2

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