Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach — JOP

* Copyright © 2011 by American Society of Clinical Oncology

Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach

1. Marilyn Huang, MD, MS,
2. Charlotte Sun, DrPH,
3. Stephanie Boyd-Rogers, RN,
4. Jennifer Burzawa, MD,
5. Andrea Milbourne, MD,
6. Elizabeth Keeler, MD,
7. Rebecca Yzquierdo,
8. Patrick Lynch, MD, JD,
9. Susan K. Peterson, PhD, MPH and
10. Karen Lu, MD

+ Author Affiliations

1. Departments of Gynecologic Oncology, Gastrointestinal Medicine and Nutrition, and Behavioral Science, University of Texas M.D. Anderson Cancer Center, Houston, TX

1. Corresponding author: Karen H. Lu, MD, P.O. Box 301439, Houston TX 77230-1439; e-mail: khlu@mdanderson.org.

Abstract

Background: Endometrial and colorectal cancers are the most common cancers in Lynch syndrome. Consensus guidelines recommend annual endometrial biopsy (EMB) and regular colonoscopies. We assessed the feasibility of concurrently performing EMB and colonoscopy and evaluated women's perception of pain, satisfaction, and acceptability.

Methods: From July 2002 to December 2009, women who had a gene mutation for Lynch syndrome, met the Amsterdam II criteria, or had a high-risk situation that required screening were prospectively enrolled. After conscious sedation, the procedures were sequentially performed. Patients completed pre- and postprocedure questionnaires assessing pain, level of satisfaction, and acceptability. The Wilcoxon rank test and Mann-Whitney test were used to compare pain scores.

Results: Forty-two women completed the study. Median age was 37 years (range, 25 to 73). Nineteen had previously had an EMB in the office setting. Women reported significantly lower median levels of pain in the combined procedure compared with previous office setting biopsies (P < .001). Regardless of parity, women reported significantly less pain for an EMB as part of the combined screen compared with an office EMB (parous, P = .003; nulliparous, P = .026). Women also reported a high level of satisfaction and more convenience in the combined procedure. All participants preferred combined to separately scheduled procedures and would recommend the combined procedure to their relatives. Conclusion: Combined colon and endometrial cancer screening is a patient-centered approach that is feasible, acceptable, and may improve adherence to Lynch syndrome screening recommendations. * Accepted September 28, 2010. Prospective Study of Combined Colon and Endometrial Cancer Screening in Women With Lynch Syndrome: A Patient-Centered Approach — JOP