ArticleGenetics in medicine : official journal of the American College of Medical Genetics2013
Implementation of routine screening for Lynch syndrome in university and safety-net health system settings: successes and challenges.
Article in Genetics in medicine : official journal of the American College of Medical Genetics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Microsatellite instability and mismatch repair deficiency prevalence among Hispanic/Latino individuals with colorectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2026Pooled it
- Comparison of universal screening in major lynch-associated tumors: a systematic review of literature.Familial cancer · 2022Pooled it
- Worldwide variation in lynch syndrome screening: case for universal screening in low colorectal cancer prevalence areas.Familial cancer · 2021Pooled it
- Racial and Ethnic Disparities in Germline Genetic Testing of Patients With Young-Onset Colorectal Cancer.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Article
- When guidelines face reality - Lynch syndrome screening in the setting of public health system in a developing country.Journal of community genetics · 2022Article
- Article
- Universal tumor screening for Lynch syndrome: Perceptions of Canadian pathologists and genetic counselors of barriers and facilitators.Cancer medicine · 2019Article
- Universal tumor screening for Lynch syndrome: perspectives of Canadian pathologists and genetic counselors.Journal of community genetics · 2019Article
- Modified capture-recapture estimates of the number of families with Lynch syndrome in Central Ohio.Familial cancer · 2019Article
- Article
- Successful implementation of Lynch syndrome screening in a safety net institution.Journal of community genetics · 2016Article
- Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.Journal of personalized medicine · 2016Article
- A single institution experience in compliance with universal screening for Lynch syndrome in colorectal cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Article
- Screening for Lynch syndrome: it is time to shift the focus.Digestive diseases and sciences · 2015Article
- When is Genomic Testing Cost-Effective? Testing for Lynch Syndrome in Patients with Newly-Diagnosed Colorectal Cancer and Their Relatives.Healthcare (Basel, Switzerland) · 2015Article
- Clinical decision support for whole genome sequence information leveraging a service-oriented architecture: a prototype.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2014Article
- Genetic testing strategies in newly diagnosed endometrial cancer patients aimed at reducing morbidity or mortality from lynch syndrome in the index case or her relatives.PLoS currents · 2013Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeRoutine screening for evidence of DNA mismatch repair abnormalities can identify colorectal cancer patients with Lynch syndrome, but impact in usual care settings requires study. After implementing routine screening at our university and safety-net health systems as usual practice, our aims were to determine outcomes, including screening process quality.
methodsWe conducted a retrospective cohort study from 1 May 2010 to 1 May 2011. Screening included reflexive immunohistochemistry to evaluate DNA mismatch repair protein expression for patients with colorectal cancer aged ≤70 years, with a cancer genetics team following up results. Screening outcomes, as well as challenges to a high-quality screening process were evaluated.
resultsWe included 129 patients (mean age 56 years, 36% female); 100 had immunohistochemistry screening completed. Twelve patients had abnormal immunohistochemistry: four with definite Lynch syndrome, four with probable Lynch syndrome, and three without Lynch syndrome; one patient had an incomplete work-up. Lynch syndrome was confirmed for 6/13 asymptomatic relatives tested. Screening process quality was optimal for 77.5% of patients. Barriers to optimal quality screening included ensuring reflexive immunohistochemistry completion, complete follow-up of abnormal immunohistochemistry, and timely incorporation of results into clinical decision making.
conclusionUsual care implementation of routine screening for Lynch syndrome can result in significant rates of detection, even in a largely safety-net setting. To optimize implementation, challenges to high-quality Lynch syndrome screening, such as ensuring reflexive screening completion and clinically indicated genetic testing and follow-up for abnormal screens, must be identified and addressed.
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