Colonoscopy screening shows differential benefit in Lynch syndrome by gene

▪ SCREENING

More frequent colonoscopy screenings resulting in an increased number of adenomas detected effectively reduces CRC risk in those with a pathogenic variant in MSH2, but MLH1 carriers did not experience the same benefit; after 10 years, CRC risk among individuals with adenomas was 7.9% in MLH1 males versus 4.0% in MSH2 males. The inverse relationship between adenoma detection and CRC risk in MSH2 carriers enhances understanding of the adenoma-carcinoma sequence, while the lack of association in MLH1 carriers suggests alternative carcinogenic pathways. (J Natl Cancer Inst)