Statement | Responses (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.