A 39-year-old woman is found to have a pathogenic MLH1 variant after her brother develops colorectal cancer at 36. She is asymptomatic and

Question

A 39-year-old woman is found to have a pathogenic MLH1 variant after her brother develops colorectal cancer at 36. She is asymptomatic and colonoscopy 18 months ago was normal. She asks about risk reduction. What is the most appropriate management?

Accepted Answer

Regular colonoscopic surveillance and discussion of daily aspirin chemoprevention

Answer

Annual CT colonography instead of colonoscopy as the preferred next step

Answer

Faecal immunochemical testing every 2 years alone as the preferred next step

Answer

Subtotal colectomy despite normal colonoscopy as the preferred next step

Answer

No surveillance until age 60 as the preferred next management strategy

Lynch syndrome — ESEGH MCQ

A 39-year-old woman is found to have a pathogenic MLH1 variant after her brother develops colorectal cancer at 36. She is asymptomatic and colonoscopy 18 months ago was normal. She asks about risk reduction. What is the most appropriate management?