Journal Article

A Single Institution Experience in Compliance with Universal Screening for Lynch Syndrome in Colorectal Cancer

Wainberg, Zev, Yoo, James, Hecht, J. Randolph, Lin, Anne Y., Russell, Marcia M., Hill, Amy L., Sumra, Kirandeep K., Ko, Clifford Y., Hart, Steven

2015

Overview

Background Detection of Lynch syndrome has the potential to reduce morbidity and mortality among patients and their family members due to beneficial screening and treatment options. Several institutions have begun to adopt universal rather than risk-stratified screening protocols, but the lack of 100 % compliance rates requires identification of system-level interventions to improve screening practices. Objective We aimed to identify patient, tumor, and system factors associated with lack of screening and identify system-based interventions to improve Lynch syndrome screening. Design and Settings This study is a retrospective analysis of Lynch syndrome screening among colorectal cancer patients undergoing surgery in a single healthcare system. Patients Two hundred and sixty-two patients who underwent surgery for colorectal cancer were studied. Main Outcome Measures Rate of Lynch syndrome screening. Results We identified that 75 % of the total cohort was screened for Lynch syndrome. Of patients under the age of 50, 78 % percent were screened. Lower screening rates were found among patients with complete pathologic tumor response and lower pathologic stage of tumor. Higher screening rates were found at the academic hospital and with colorectal surgeons. In multivariable logistic regression analysis, lower screening rates were associated with community hospital location (OR, 0.22; 95 % CI, 0.08–0.56). Limitations Results may not be generalizable to different hospital settings. Conclusions Several potential system-level interventions were identified to improve screening rates including an emphasis on improved provider communication.

• Publisher: Springer US,Springer Nature B.V
• Subject: Adenocarcinoma - diagnosis / Adult / Aged / Colorectal cancer / Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis / Compliance / Early Detection of Cancer / Female / Gastroenterology / Genetic testing / Guideline Adherence / Hospitals / Humans / Male / Medicine / Medicine & Public Health / Middle Aged / Mortality / Mutation / Original Article / Pathology / Patients / Protein expression / Proteins / Retrospective Studies / Surgeons / Surgery