title: Implementing screening for Lynch syndrome among patients with newly diagnosed colorectal cancer: summary of a public health/clinical collaborative meeting.
abstract: Lynch syndrome is the most common cause of inherited colorectal cancer, accounting for approximately 3% of all colorectal cancer cases in the United States. In 2009, an evidence-based review process conducted by the independent Evaluation of Genomic Applications in Practice and Prevention Working Group resulted in a recommendation to offer genetic testing for Lynch syndrome to all individuals with newly diagnosed colorectal cancer, with the intent of reducing morbidity and mortality in family members. To explore issues surrounding implementation of this recommendation, the Centers for Disease Control and Prevention convened a multidisciplinary working group meeting in September 2010. This article reviews background information regarding screening for Lynch syndrome and summarizes existing clinical paradigms, potential implementation strategies, and conclusions which emerged from the meeting. It was recognized that widespread implementation will present substantial challenges, and additional data from pilot studies will be needed. However, evidence of feasibility and population health benefits and the advantages of considering a public health approach were acknowledged. Lynch syndrome can potentially serve as a model to facilitate the development and implementation of population-level programs for evidence-based genomic medicine applications involving follow-up testing of at-risk relatives. Such endeavors will require multilevel and multidisciplinary approaches building on collaborative public health and clinical partnerships.
authors.affiliation: Office of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. cbellcr@emory.edu
authors.forename: Cecelia A
authors.initials: CA
authors.lastname: Bellcross
authors.forename: Sara R
authors.initials: SR
authors.lastname: Bedrosian
authors.forename: Elvan
authors.initials: E
authors.lastname: Daniels
authors.forename: Debra
authors.initials: D
authors.lastname: Duquette
authors.forename: Heather
authors.initials: H
authors.lastname: Hampel
authors.forename: Kory
authors.initials: K
authors.lastname: Jasperson
authors.forename: Djenaba A
authors.initials: DA
authors.lastname: Joseph
authors.forename: Celia
authors.initials: C
authors.lastname: Kaye
authors.forename: Ira
authors.initials: I
authors.lastname: Lubin
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Meyer
authors.forename: Michele
authors.initials: M
authors.lastname: Reyes
authors.forename: Maren T
authors.initials: MT
authors.lastname: Scheuner
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Schully
authors.forename: Leigha
authors.initials: L
authors.lastname: Senter
authors.forename: Sherri L
authors.initials: SL
authors.lastname: Stewart
authors.forename: Jeanette
authors.initials: J
authors.lastname: St Pierre
authors.forename: Judith
authors.initials: J
authors.lastname: Westman
authors.forename: Paul
authors.initials: P
authors.lastname: Wise
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Yang
authors.forename: Muin J
authors.initials: MJ
authors.lastname: Khoury
mesh_terms: D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics; D003299:Cooperative Behavior; D005820:Genetic Testing; D006801:Humans; D033183:Interdisciplinary Communication; D011634:Public Health