History, genetics, and strategies for cancer prevention in Lynch syndrome

Clin Gastroenterol Hepatol. 2014 May;12(5):715-27; quiz e41-3. doi: 10.1016/j.cgh.2013.06.031. Epub 2013 Jul 23.


Colorectal cancer (CRC) is the most common gastrointestinal malignancy and the third cause of cancer death in men and women in the United States. The majority of CRC cases diagnosed annually are due to sporadic events, but up to 6% are attributed to known monogenic disorders that confer a markedly increased risk for the development of CRC and multiple extracolonic malignancies. Lynch syndrome is the most common inherited CRC syndrome and is associated with mutations in DNA mismatch repair genes, mainly MLH1 and MSH2 but also MSH6, PMS2, and EPCAM. Although the risk of CRC and endometrial cancer may approach near 75% and 50%, respectively, in gene mutation carriers, the identification of these individuals and at-risk family members through predictive genetic testing provides opportunities for cancer prevention including specialized cancer screening, intensified surveillance, and/or prophylactic surgeries. This article will provide a review of the major advances in risk assessment, molecular genetics, DNA mutational analyses, and cancer prevention and management made since Lynch syndrome was first described 100 years ago.

Keywords: Colorectal Cancer; Lynch Syndrome.

Publication types

  • Historical Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / prevention & control*
  • Colorectal Neoplasms, Hereditary Nonpolyposis / diagnosis*
  • Colorectal Neoplasms, Hereditary Nonpolyposis / genetics
  • Colorectal Neoplasms, Hereditary Nonpolyposis / history
  • Colorectal Neoplasms, Hereditary Nonpolyposis / prevention & control*
  • Female
  • Gastroenterology / methods
  • Gastroenterology / trends*
  • Genetic Testing / methods
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Male
  • Middle Aged
  • Surgical Procedures, Operative / methods
  • United States / epidemiology