Table 3

Statements for which minimum number of responses and/or consensus was not achieved

StatementResponses (n) (minimum required: 50)Proportion of respondents indicating ‘agree/ strongly agree’ or ‘yes’ (%) (minimum required: 80%)
For all colorectal and endometrial cancers, comprehensive testing (BRAF/MLH1 promoter hypermethylation testing/germline testing/somatic MMR next-generation sequencing and loss of heterozygosity analysis) should be performed to rule out a diagnosis of Lynch syndrome prior to making surveillance recommendations.54 60
Additional investigations for patients with dMMR cancers beyond standard testing as per DG2711/DG4212 and germline genetic testing depend on prior probability of heritable cause for cancer and are not necessary where clinical suspicion is low. 45 60
For proband with dMMR cancer diagnosed >65 years of age without a family history of Lynch syndrome-associated cancers, colorectal surveillance in the proband and their relatives should be guided by the clinical picture and specialist MDT discussion. 24 83
Lynch-equivalent screening (for probands and first-degree relatives) is only appropriate where clinical suspicion of a heritable cause for dMMR is high. 47 75
The extent of testing for unexplained dMMR prior to making surveillance recommendations may be adjusted for non-colorectal/non-endometrial cancers. 7 100
Age and family history should be considered when deciding to proceed to additional testing beyond BRAF/MLH1 hypermethylation and germline testing, for colorectal and endometrial cancers to rule out a diagnosis of Lynch syndrome prior to making surveillance recommendations. 13 69
  • Where minimum number of responses have not been achieved, or where the proportion of respondents indicating "agree"/"strongly agree" is less than 80%, the values are in bold.