title: The results of gynecologic surveillance in families with hereditary nonpolyposis colorectal cancer.
abstract: OBJECTIVE
  We aimed to estimate the incidence rate of endometrial cancer (EC) and to evaluate the results of EC-surveillance in hereditary nonpolyposis colorectal cancer (HNPCC) families.
  
  
  METHODS
  All at-risk women recommended for EC-surveillance by the HNPCC-register-2959 women (19,334women years)-were included. Data on EC-surveillance were available for 871 women (6894women years), who had performed 1945 surveillance visits. The average surveillance period was 7.9 (range 0.1-21.7) years and 46% of the women had had less than 3years between their visits.
  
  
  RESULTS
  During 19,334women years, 60 women with gynecological malignancies or premalignancies were diagnosed. Thirty-nine women had EC. Of these, 31 were from families with identified MMR gene mutations with the median age at diagnosis of 54 (39-83) years (Incidence Rate, IR=0.63 per 100women years) and four women from each Amsterdam (AMS)-positive and AMS-like families (median age 64 (55-73) years, IR=0.06 and 0.05 per 100women years, respectively, p<.0001). Among the 871 surveilled women, 13 EC were found: 7/13 cases were diagnosed by surveillance examination-two as prevalent cancers, diagnosed at the first visit-and 6/13 based on symptoms. In addition, five complex atypical hyperplasias and four ovarian cancers (OCs) were diagnosed. All these women were MMR mutation carriers.
  
  
  CONCLUSIONS
  Based on 19,334women years of EC-surveillance, our analysis provides a thorough estimation of the EC risk in women with an MMR mutation, or suspected of having Lynch syndrome. We conclude that EC surveillance should only be targeted at MMR-mutation carriers.
authors.affiliation: HNPCC-Register, Department of Gastroenterology and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; Department of Gynaecology and Obstetrics, OUH - Odense University Hospital, Denmark. Electronic address: ketabi@dadlnet.dk.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Ketabi
authors.affiliation: Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Gerdes
authors.affiliation: Department of Obstetrics and Gynecology, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Berit
authors.initials: B
authors.lastname: Mosgaard
authors.affiliation: HNPCC-Register, Department of Gastroenterology and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Ladelund
authors.affiliation: HNPCC-Register, Department of Gastroenterology and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; Department of Surgical Gastroenterology, Aalborg University Hospital, Denmark.
authors.forename: Inge
authors.initials: I
authors.lastname: Bernstein
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000453:epidemiology* / Q000235:genetics; D053843:DNA Mismatch Repair / Q000235:genetics; D055088:Early Detection of Cancer / Q000379:methods*; D004714:Endometrial Hyperplasia / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D058869:Gynecological Examination; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D018579:Patient Selection
keywords: Endometrial cancer; Gynecologic surveillance; HNPCC; Lynch syndrome