Screening and diagnosis of endometrial cancer in Lynch syndrome |
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Authors: | Caroline Cornou Anne Sophie Bats Charlotte Ngo L& eacute a Rossi Perrine Capmas Pierre Laurent-Puig Ch& eacute razade Bensaid Claude Nos Marie Aude Lefr& egrave re-Belda Fabrice L& eacute curu |
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Affiliation: | Caroline Cornou, Anne Sophie Bats, Charlotte Ngo, Léa Rossi, Perrine Capmas, Pierre Laurent-Puig, Chérazade Bensaid, Claude Nos, Marie Aude Lefrère-Belda, Fabrice Lécuru, Department of Gynecologic Oncology, European Hospital Georges Pompidou, University of Paris Descartes, 75015 Paris, France |
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Abstract: | Lynch syndrome (LS) is an autosomal dominant inherited cancer predisposition syndrome caused by a mismatch of DNA repair (MMR system). Lifetime risk of developing endometrial and ovarian cancer in LS is higher than in the general population and gynecologic screening appears interesting. Screening is based on several tests: pelvic ultrasound, endometrial biopsy and hysteroscopy for endometrial cancer, pelvic ultrasound and CA125 for ovarian cancer. Those tests appear efficient for the diagnosis of gynecologic cancers in LS. Nevertheless, screening tests have not proved clinical benefit until now, and potential problems of compliance, risk of false negative cases, and interval cancer associated with screening do justify offering prophylactic surgery to patients. Women with LS should be informed of the potential benefits and risks of screening and the importance of evaluation in case of gynecologic symptoms or abnormal bleeding. Chemoprevention by progestin-containing oral contraceptives and the treatment of premalignant lesion are available options for reducing the risk of endometrial cancer in LS population. |
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Keywords: | Lynch syndrome Endometrial cancer Ovarian cancer Gynecologic screening Prophylactic hysterectomy |
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