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
30–35Gastroduodenoscopy*1–2
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