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Check colon tumors for signs of syndrome, study suggests

COLUMBUS , Ohio A new study suggests that, after surgery, all colon tumors should be tested to learn if the patient may have an inherited syndrome that carries an extremely high risk of cancer. It also suggests that this prescreening can be done using a relatively inexpensive microscopy test already used in hospital pathology laboratories.

The study showed that two to three percent(at least one in 45) of people with colon cancer probably have mutations for the inherited syndrome, known as Lynch syndrome (also known as hereditary nonpolyposis colon cancer, or HNPCC).

Prescreening for Lynch syndrome will help determine if the person and his or her relatives should consider genetic counseling and testing for the syndrome. In addition, the test might help doctors better estimate a patient's long-term prognosis.

The study, led by researchers with The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, is published in the May 5 issue of the New England Journal of Medicine.

Lynch syndrome is caused by a mutation in one of four genes. One out of two first-degree relatives of those with the syndrome are also likely to have the mutations.

"These are particularly bad mutations," says principal investigator Albert de la Chapelle, professor of molecular virology, immunology and medical genetics at Ohio State . "A person who has one of these mutations has an almost 100 percent lifetime risk of cancer."

The risk is highest for colon cancer, followed by a lower risk of uterine cancer and several other cancers, he says.

"People with Lynch syndrome need closer cancer surveillance, with annual colonoscopies starting at age 25," de la Chapelle says. "This has been proven to prevent cancer and to prevent death from cancer."

In addition, he says, it is important for someone in a high-risk family to know that he or she lacks
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Contact: Darrell E. Ward
Ward-15@medctr.osu.edu
614-293-3737
Ohio State University
5-May-2005


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