Case Number 3897
Request Date 19/11/2014
Completion Date 24/11/2014

 

Details of the Request

The Royal College of Pathologists (RCPath) minimum dataset guidelines for colorectal cancer, published in July 2014, recommends performing mismatch repair immunohistochemistry testing for Lynch syndrome in patients diagnosed with bowel cancer under 50 years at time of diagnosis.

We would be grateful if you could answer the following questions on the implementation of Lynch syndrome testing:

  1. Are all patients diagnosed with bowel cancer under 50 years of age tested for Lynch Syndrome at diagnosis within your Trust?
     
  2. Is Lynch syndrome testing carried out using MMR immunohistochemistry? If not, which method is being used to test for Lynch syndrome?
     
  3. If testing for Lynch syndrome is not carried out, are you intending to implement the recommendation for Lynch syndrome testing? If so, by when?
     
  4. If no, please could you tell us why you will not be implementing the guidelines?

 

Details of the Response

1. Are all patients diagnosed with bowel cancer under 50 years of age tested for Lynch Syndrome at diagnosis within your Trust?

Tests are not carried out at out Trust. All our patients that require genetics testing are referred to:

South West Thames Regional Genetics Service, Medical Genetics Unit St George’s university of London, Cranmer Terrace, London SW17 0RE

We refer patients who are under the age of 50, or who are diagnosed older than that but who have a significant family history of Lynch Syndrome.

 

2. Is Lynch syndrome testing carried out using MMR immunohistochemistry? If not, which method is being used to test for Lynch syndrome?

N/A. See above.

 

3. If testing for Lynch syndrome is not carried out, are you intending to implement the recommendation for Lynch syndrome testing? If so, by when?

See answer to question 1 above.

 

4. If no, please could you tell us why you will not be implementing the guidelines?

N/A.

 

Follow Up Question

I would like to see a clarification on your response to question one: Does your response “All our patients that require genetics testing are referred” include referral of all patients with bowel cancer under the age of 50 at diagnosis?

 

Follow Up Response

All patients with a significant family history of related cancer are referred for Genetics screening. Those patients who are under the age of 50 but with no family history are also referred if they would like to be.

 

Follow Up Question

Would you be able to clarify whether any decision has been made on whether all patients under 50 diagnosed with colorectal cancer will be referred for Lynch syndrome screening as per the Royal College of Pathologist minimum dataset guideline, which was introduced in July 2014? Or is all pathology carried out at St George’s so this decision would rest with them?

 

Follow Up Response

All pathology is carried out at St George’s so this decision would rest with them.