If a person has a Lynch Syndrome gene mutation, what are the options for cancer screening and prevention?
People with Lynch syndrome have several choices. At a minimum, they should have careful screening to help find cancers at the earliest possible stage, when they are most easily treated. For colon cancer this means having a yearly colonoscopy to detect and remove precancerous polyps or to diagnose early cancers. In women with Lynch syndrome, yearly pelvic examination, ultrasound examination and small biopsies of the uterus are recommended in order to screen for uterine cancer. Screening for ovarian cancer is not very effective, however, women may choose to have an additional blood test in an attempt to help find ovarian cancer early. Screening recommendations for the less common Lynch Syndrome cancers are determined separately for each family. Another option is to have surgery to remove at risk body parts before cancer develops. This is called risk reducing surgery. Risk reducing colectomy (removal of the colon) is generally only considered when a person is unable to follow the colonoscopy screening recommendation. Risk reducing hysterectomy (with removal of the uterus, ovaries and fallopian tubes) is often considered by women with Lynch syndrome as they approach the age of natural menopause. Finally, there is an option available to reduce the risk for colorectal cancer among individuals with Lynch syndrome. It has been shown that daily use of 600mg of aspirin for at least 2 years lowers the risk for colon cancer by almost 60% inindividuals. The cancer risk reduction begins around 45 years after the individuals started taking aspirin. It is still not known what the best amount of aspirin is inorder to decrease the colon cancer risk or the total amount of time that individuals need to take the aspirin.1