Prophylactic Surgery to Reduce the Risk of Gynecologic Cancers in the Lynch Syndrome

Women with the Lynch syndrome (hereditary nonpolyposis colorectal cancer) are at high risk for endometrial cancer and at increased risk for ovarian cancer. In this retrospective cohort study, there were no cases of either cancer among women who underwent prophylactic hysterectomy with bilateral salpingo-oophorectomy, as compared with women who did not undergo prophylactic surgery. The risk reduction was significant for endometrial cancer, although not for ovarian cancer. These results support the consideration of prophylactic hysterectomy with bilateral salpingo-oophorectomy to reduce the risk of cancer in women with the Lynch syndrome. In this retrospective cohort study, there were no cases of endometrial or ovarian cancer among women with the Lynch syndrome who underwent prophylactic hysterectomy with bilateral salpingo-oophorectomy. The Lynch syndrome (hereditary nonpolyposis colorectal cancer) is an autosomal dominant cancer-susceptibility syndrome caused by a germ-line mutation in one of the DNA-mismatch repair genes. 1 – 4 It is associated with an early onset of cancer and the development of multiple types of cancer, including cancer of the colon and rectum, endometrium, ovary, small bowel, ureter, and renal pelvis. The lifetime risk of endometrial cancer for women with the Lynch syndrome is 40 to 60 percent, which equals or exceeds their risk of colorectal cancer. In addition, they have a 10 to 12 percent lifetime risk of ovarian cancer. 5 , 6 Up . . .