title: A single institution experience in compliance with universal screening for Lynch syndrome in colorectal cancer.
abstract: BACKGROUND
  Detection of Lynch syndrome has the potential to reduce morbidity and mortality among patients and their family members due to beneficial screening and treatment options. Several institutions have begun to adopt universal rather than risk-stratified screening protocols, but the lack of 100 % compliance rates requires identification of system-level interventions to improve screening practices.
  
  
  OBJECTIVE
  We aimed to identify patient, tumor, and system factors associated with lack of screening and identify system-based interventions to improve Lynch syndrome screening.
  
  
  METHODS
  This study is a retrospective analysis of Lynch syndrome screening among colorectal cancer patients undergoing surgery in a single healthcare system.
  
  
  METHODS
  Two hundred and sixty-two patients who underwent surgery for colorectal cancer were studied.
  
  
  METHODS
  Rate of Lynch syndrome screening.
  
  
  RESULTS
  We identified that 75 % of the total cohort was screened for Lynch syndrome. Of patients under the age of 50, 78 % percent were screened. Lower screening rates were found among patients with complete pathologic tumor response and lower pathologic stage of tumor. Higher screening rates were found at the academic hospital and with colorectal surgeons. In multivariable logistic regression analysis, lower screening rates were associated with community hospital location (OR, 0.22; 95 % CI, 0.08-0.56).
  
  
  CONCLUSIONS
  Results may not be generalizable to different hospital settings.
  
  
  CONCLUSIONS
  Several potential system-level interventions were identified to improve screening rates including an emphasis on improved provider communication.
authors.affiliation: Department of Surgery, David Geffen School of Medicine, University of California at Los Angeles, 10833 Le Conte Ave, 72-247 CHS, Los Angeles, CA, 90095, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Hill
authors.forename: Kirandeep K
authors.initials: KK
authors.lastname: Sumra
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Russell
authors.forename: James
authors.initials: J
authors.lastname: Yoo
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
authors.forename: Steven
authors.initials: S
authors.lastname: Hart
authors.forename: Zev
authors.initials: Z
authors.lastname: Wainberg
authors.forename: J Randolph
authors.initials: JR
authors.lastname: Hecht
authors.forename: Anne Y
authors.initials: AY
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies