Annual gynaecological surveillance in Lynch Syndrome

J.H. de Hullu
Department of Gynaecology; Radboud University Nijmegen Medical Centre

Introduction: Annual gynecological surveillance has been recommended for female members of families with Lynch Syndrome because of elevated lifetime risk to develop endometrial and ovarian cancer. The aim of this study was to evaluate the efficacy of our gynecological surveillance and the introduction of routine endometrial sampling.

Methods: Women from families with positive revised Amsterdam criteria or with a proven mutation in one of the mismatch repair genes underwent annual gynecological surveillance. Since January 2006 endometrial sampling became part of standard surveillance.

Results:  A total number of 100 women underwent 285 surveillance visits. The 64 visits with routine endometrial sampling diagnosed four atypical hyperplasias. This was significantly more than one atypical hyperplasia and two endometrial carcinomas after 28 samples performed because of abnormal surveillance results in 221 visits. There were no interval carcinomas.

Conclusions: Gynecological surveillance in females with Lynch Syndrome is efficient for finding endometrial abnormalities with a sgnificant increase in diagnosing endometrial premaligncancies after the introduction of routine endometrial sampling.