Report on a colorectal Lynch syndrome clinic across the North-East London Cancer Alliance region

Abstract

Background: Lynch syndrome is a genetic condition that significantly raises the risk of bowel cancer and increases the likelihood of other cancers, such as uterine and ovarian cancers. Aims: The study aimed to evaluate the characteristics of colorectal cancer (CRC) patients seen in a lynch syndrome (LS) clinic across the North East London Cancer Alliance (NELCA) region, and identify patient- and cancer-related features, such as location and staging. Method: This study used a population-based observational cohort analysis in the NELCA region, across three NHS trusts. The study was run between 24 January, 2023, and 23 January, 2024. Data on 28 CRC patients were collected, then reviewed in a colorectal genetic clinic. A total of 26 patients agreed to take part in LS testing; two of the cohort refused. Clinical-specific data were routinely collected following the patients’ initial clinical appointment. Prevalence of LS was determined and correlated with patient characteristics (sex, ethnic background and age) and attributes relating to their cancer diagnosis (tumour location, tumour size and spread into nearby tissue, as per TNM staging). Results: LS was diagnosed in 6 (23%) of the 26 patients that underwent testing. An increased likelihood of LS was associated with several features, including: T3 staging, a right-sided tumour location, and being of the male sex, a White ethnic background and between 41 to 60 years of age. Conclusions: The study demonstrates the continued importance of colorectal genetic clinics in detecting LS. It exemplifies how genetic clinics can improve LS diagnosis and why it is necessary to integrate LS clinics in CRC patient care.