European Guidance from EHTG and ESCP for Lynch syndrome: an updated third edition of the “Mallorca Guidelines” based on Gene and Gender

Research output: Contribution to journalArticle

  • Authors:
  • European Hereditary Tumour Group

Abstract

Background Lynch syndrome (LS) is the most common genetic predisposition for hereditary cancer but remains under-diagnosed. Large prospective observational studies have recently increased understanding of the effectiveness of colonoscopy surveillance and the heterogeneity of cancer risk between genotypes. The need for gene- and gender-specific guidelines has been acknowledged. Method European Hereditary Tumour Group (EHTG) and European Society of Coloproctology (ESCP) developed a multidisciplinary working group consisting of surgeons, clinical and molecular geneticists, pathologists, epidemiologists, gastroenterologists, and patient representation to conduct a graded evidence review. The previous ‘Mallorca guideline’ format was used to revise the clinical guidance. Consensus for the guidance statements were acquired by three Delphi voting rounds. Results Recommendations for clinical and molecular identification of LS, surgical and endoscopic management of LS-associated colorectal cancer and preventive measures for cancer were produced. The emphasis was on surgical and gastroenterological aspects of the cancer spectrum. Manchester consensus guidelines for gynaecological management were endorsed. Executive and layperson summaries were provided. Conclusion The recommendations from the EHTG and ESCP for identification of LS patients, colorectal surveillance, surgical management of colorectal cancer, lifestyle and chemoprevention in LS that reached a consensus (>80%) are presented.

Bibliographical metadata

Original languageEnglish
JournalBritish Journal of Surgery
Publication statusAccepted/In press - 14 Jun 2020