Risk-reducing gynaecological surgery in Lynch syndrome: results of an international survey from the Prospective Lynch Syndrome Database

James Hill, Neil Ryan, D Gareth Evans, Emma Crosbie, et al.

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. To survey risk-reducing hysterectomy and bilateral salpingo-oophorectomy (BSO) practice and advice regarding hormone replacement therapy (HRT) in women with Lynch syndrome.

Methods. We conducted a survey in 31 contributing centres from the Prospective Lynch Syndrome Database (PLSD), which incorporates 18 countries worldwide. The survey covered local policies for risk-reducing hysterectomy and BSO in Lynch syndrome, the timing at which these measures are offered, the involvement of stakeholders and advice regarding HRT.

Results. Risk-reducing hysterectomy and BSO is offered to path_MLH1 and path_MSH2 carriers in 20/21 (95%) contributing centres, to path_MSH6 carriers in 19/21 (91%), and to path_PMS2 carriers in 14/21 (67%). Regarding the involvement of stakeholders, there is global agreement (90%) that risk-reducing surgery should be offered to women, and that this discussion may involve gynaecologists, genetic counselors and/or medical geneticists. Prescription of estrogen-only HRT is offered by 15/21 (71%) centres to women of a variable age range (35 - 55 years).

Conclusions. Most centres offer risk-reducing gynaecological surgery to carriers of path_MLH1, path_MSH2 and path_MSH6 variants but less so for path_PMS2 carriers. There is wide variation in how, when and to whom this is offered. The Manchester International Consensus Group developed recommendations to harmonize clinical practice across centres but there is a clear need for more research.
Original languageEnglish
JournalJournal of Clinical Medicine
Early online date18 Jul 2020
DOIs
Publication statusPublished - 2020

Keywords

  • Lynch Syndrome
  • endometrial cancer
  • ovarian cancer
  • risk reducing surgery

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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