Background: Lynch syndrome is the most common genetic predisposition for hereditary cancer but remains underdiagnosed.
Large prospective observational studies have recently increased understanding of the effectiveness of colonoscopic
surveillance and the heterogeneity of cancer risk between genotypes. The need for gene- and gender-specific guidelines has been
acknowledged.
Methods: The European Hereditary Tumour Group (EHTG) and European Society of Coloproctology (ESCP) developed a multidiscipli nary working group consisting of surgeons, clinical and molecular geneticists, pathologists, epidemiologists, gastroenterologists, and
patient representation to conduct a graded evidence review. The previous Mallorca guideline format was used to revise the clinical
guidance. Consensus for the guidance statements was acquired by three Delphi voting rounds.
Results: Recommendations for clinical and molecular identification of Lynch syndrome, surgical and endoscopic management of
Lynch syndrome-associated colorectal cancer, and preventive measures for cancer were produced. The emphasis was on surgical
and gastroenterological aspects of the cancer spectrum. Manchester consensus guidelines for gynaecological management were en dorsed. Executive and layperson summaries were provided.
Conclusion: The recommendations from the EHTG and ESCP for identification of patients with Lynch syndrome, colorectal surveil lance, surgical management of colorectal cancer, lifestyle and chemoprevention in Lynch syndrome that reached a consensus (at
least 80 per cent) are presented
