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Availability and scope of integrated screening for patients with Lynch syndrome
Author(s) -
Frey Melissa K.,
Pauk Sara J.,
Caputo Thomas A.,
Moss Haley A.,
Sapra Katherine J.,
Gerber Deanna,
Stewart Joshua D.
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.05.023
Subject(s) - medicine , lynch syndrome , urinalysis , colonoscopy , hysterectomy , pelvic examination , modalities , general surgery , cancer , gynecology , family medicine , colorectal cancer , radiology , urinary system , social science , dna mismatch repair , sociology
Objective To assess the availability and capacity of US‐based integrated centers for the management of Lynch syndrome. Methods A cross‐sectional survey of practice patterns in the care of patients with Lynch syndrome was conducted at 33 National Cancer Institute‐designated cancer centers in the USA from March 1 to June 1, 2013. Each cancer center was contacted by telephone and the caller used a uniform scripted greeting and survey format. Results All centers routinely recommended colonoscopy. Other recommended screening modalities were hysterectomy and bilateral salpingo‐oophorectomy (29/33; 88%), endoscopy (27/33; 82%), urinalysis (23/33; 70%), endometrial sampling (21/33; 64%), dermatologic examination (19/32; 59%), pelvic ultrasonography (18/33; 55%), serum CA125 level (14/33; 42%), urine cytology (14/33; 42%), computed tomography (1/33; 3%), and magnetic resonance imaging (1/33; 3%). Each center had a multidisciplinary team but the composition varied. A designated team leader was present at 21 centers (64%). Having a team leader was associated with an increased likelihood of recommending endoscopy ( P = 0.04) and dermatologic surveillance ( P = 0.01). Only 23 centers (70%) had a system in place for communicating follow‐up with patients. Conclusion The lack of consensus in practice patterns recorded among participating centers probably reflected the limited existing evidence on the usefulness of most screening modalities.