title: Outcomes of screening endometrial cancer patients for Lynch syndrome by patient-administered checklist.
abstract: OBJECTIVE
  The aims of this study were to implement a patient-administered checklist designed to identify endometrial cancer patients at elevated risk for Lynch syndrome; measure subsequent genetic counseling and testing; and identify differences between those who attended genetic counseling and those who did not.
  
  
  METHODS
  We developed a 4-item yes/no checklist of personal and family history risk factors for Lynch syndrome-associated endometrial cancer and recommended referral for genetic counseling for patients meeting any of the criteria. Retrospective chart review was performed to determine subsequent genetic counseling and testing outcomes over a 15 month period.
  
  
  RESULTS
  6/387 (1.6%) of endometrial cancer patients tested positive for a Lynch syndrome mutation. 4/24 (17%) of endometrial cancer patients who met referral criteria and attended genetic counseling tested positive. 38/70 (55%) of patients who met referral criteria were not seen for genetic counseling. Patients who were diagnosed with endometrial cancer at younger ages, who had primary surgery at our institution, or who met more than one referral criteria were more likely to be seen for genetic counseling.
  
  
  CONCLUSIONS
  Endometrial cancer patients who met referral criteria and attended genetic counseling comprised a population enriched for Lynch syndrome. This approach allowed Lynch syndrome evaluation resources to be targeted to a population of patients that is high risk and interested in the information. The referral rate of at-risk patients needs to be improved, and allocating resources towards this goal could increase the identification of Lynch syndrome while avoiding some of the pitfalls of universal screening.
authors.affiliation: Department of Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: msdaniel@mdanderson.org.
authors.forename: Molly S
authors.initials: MS
authors.lastname: Daniels
authors.forename: Diana L
authors.initials: DL
authors.lastname: Urbauer
authors.forename: Azadeh
authors.initials: A
authors.lastname: Zangeneh
authors.forename: Brittany A L
authors.initials: BA
authors.lastname: Batte
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Dempsey
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis* / Q000235:genetics; D059026:Diagnostic Self Evaluation; D016889:Endometrial Neoplasms / Q000235:genetics* / Q000473:pathology; D005192:Family Health; D005260:Female; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D055815:Young Adult
keywords: Endometrial cancer; Genetic counseling; Genetic testing; Lynch syndrome