Recognition of Lynch Syndrome Amongst Newly Diagnosed Colorectal Cancers at St. Paul’s Hospital
Table 1
Amsterdam II, Revised Bethesda Guidelines, and HCP Referral Criteria.
Amsterdam Criteria II
Requiring three or more relatives with Lynch-associated cancer in addition to the following
(1) One affected patient should be a first-degree relative of the other two
(2) Two or more successive generations are affected
(3) One or more affected relatives received diagnosis at age younger than 50 years
(4) FAP is excluded. Tumours should be verified by pathological examination
, stomach, ovarian, pancreas, ureter, and renal pelvis
Revised Bethesda Guidelines
(1) CRC diagnosed in a patient who is younger than 50 years of age
(2) Presence of synchronous, metachronous CRC, or other Lynch-associated tumours
(3) CRC diagnosed in a patient who is younger than 60 years of age, with the presence of tumour infiltrating lymphocytes, Crohn’s-like lymphocytic reaction, mucinous/signet-ring differentiation, or medullary growth pattern
(4) CRC diagnosed in a patient with one or more first-degree relatives with a Lynch-associated tumour, with at least one of the cancers being diagnosed at age younger than 50 years
(5) CRC diagnosed in a patient with two or more first- or second-degree relatives with Lynch-associated tumours, regardless of age
