The authors have nothing to disclose. There are no competing interests.
Impact of gynecological screening in Lynch syndrome carriers with an MSH2 mutation
Version of Record online: 7 AUG 2012
© 2012 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd
Volume 83, Issue 4, pages 359–364, April 2013
How to Cite
Impact of gynecological screening in Lynch syndrome carriers with an MSH2 mutation., , , , , , .
- Issue online: 12 MAR 2013
- Version of Record online: 7 AUG 2012
- Accepted manuscript online: 6 JUL 2012 01:30PM EST
- Manuscript Revised: 4 JUL 2012
- Manuscript Received: 8 MAY 2012
- Canadian Institute for Health Research
- National Cancer Institute of Canada. Grant Number: 18223, 18226
- Atlantic Innovation Fund
- endometrial cancer;
- gynecological screening;
- Lynch syndrome;
- MSH2 mutation;
- ovarian cancer
Lifetime risk of developing endometrial cancer in Lynch syndrome carriers is very high and females are also at an increased risk of developing ovarian cancer. The aim of the study was to determine the impact of gynecological screening in MSH2 mutation carriers. Gynecological cancer incidence and overall survival was compared in female mutation carriers who received gynecological screening (cases) and in matched controls. Controls were randomly selected from non-screened mutation carriers who were alive and disease-free at the age the case entered the screening program. Median age to diagnosis of gynecological cancer was 54 years in the screened group compared to 56 years in controls (p = 0.50). Stage I or II cancer was diagnosed in 92% of screened patients compared to 71% in the control group (p = 0.17). Two of three deaths in the screened group were the result of ovarian cancer. Mean survival in the screened group was 79 years compared to 69 years in the control group (p = 0.11), likely associated with concomitant colonoscopy screening. Gynecological screening did not result in earlier gynecologic cancer detection and despite screening two young women died from ovarian cancer suggesting that prophylactic hysterectomy with bilateral salpingo-oophorectomy be considered in female mutation carriers who have completed childbearing.