"Watch your back" is a common saying, but maybe you should be watching your colon instead. Schedule a colonoscopy and avoid being one of the estimated 50,000 people to die this year from one of the most preventable cancers.
For those who are diagnosed with colorectal cancer (CRC), ask the surgeon or gastroenterologist to have the colon tumor tested for Lynch syndrome as well—which will be sent to a pathology lab like Salt Lake City's ARUP Laboratories for analyzing.
For CRC tumors removed from patients at the University of Utah Hospital, ARUP pathologists will automatically look for the syndrome, as well as in uterine specimens as there is increased likelihood of this syndrome in individuals with endometrial/uterine cancer as well.
However, this test is not necessarily routinely ordered by physicians and is a strong indicator as to whether families should be vigilant in screening for other types of cancers. (Sometimes tumor tissue is saved from an operation and can still be tested several years after the colon operation.)
Lynch syndrome is an inherited disorder that increases the risk of colorectal cancer with a lifetime risk of 80 percent, as well as increases the risk of cancers of the uterus, stomach, small intestine, liver, hepatobiliary tract, pancreas, upper urinary tract, brain, and skin. If a family member is diagnosed with CRC or Lynch syndrome, other members of the immediate family (siblings, parents, adult children) should consider genetic testing.
"If you have family who have had CRC or uterine cancer, especially under the age of 60, then these conversations about Lynch syndrome need to be taking place early on with your primary doctor," emphasizes University of Utah gastroenterologist Jewel Samadder, M.D., who has done extensive research on CRC.
If Lynch syndrome may be suspect, then follow up may include meeting with a genetic counselor to better understand the risks associated with the syndrome; then a blood sample may be taken to identify and look for mutations in one of the syndrome's four genes.
ARUP pathologists, who test CRC for patients nationwide, are urging physicians to test all CRC and uterine cancer patients for Lynch syndrome. Last year, the National Comprehensive Cancer Network highlighted Lynch syndrome as the most common inherited form of CRC and endorsed testing of all colorectal tumors.
"We also offer tests to determine the mutational status of colorectal cancers which are not associated with Lynch syndrome," explains Dr. Wade Samowitz, a University of Utah pathologist and a medical director at ARUP Laboratories, who specializes in gastrointestinal pathology and the molecular genetics of colorectal cancer.
"This helps the physician choose the therapy that best fits a cancer's mutational profile, also known as precision or personalized medicine," adds Samowitz.