Table 7

 Surveillance protocol in Lynch syndrome and familial clustering of colorectal cancer

DisorderLower age limit (years)ExaminationInterval (years)
CRC, colorectal cancer; MSI, microsatellite instability.
*If gastric cancer runs in the family or in countries with a high incidence of gastric cancer.
†If urinary tract cancer runs in the family.
‡Amsterdam positive families.
Lynch syndrome20–25Colonoscopy1–2
30–35Gynaecological examination, transvaginal ultrasound, aspiration biopsy1–2
30–35Abdominal ultrasound, urinalysis and cytology urine†1–2
Familial clustering of colorectal cancer without evidence of MSI‡45–50 or 5–10 before age at diagnosis of first CRC in familyColonoscopy3–5