{"id":1331,"date":"2025-02-19T16:23:00","date_gmt":"2025-02-19T16:23:00","guid":{"rendered":"https:\/\/services.nhslothian.scot\/geneticservice\/?page_id=1331"},"modified":"2025-02-19T16:26:28","modified_gmt":"2025-02-19T16:26:28","slug":"family-history-of-colorectal-and-or-lynch-related-cancer","status":"publish","type":"page","link":"https:\/\/services.nhslothian.scot\/geneticservice\/family-history-of-colorectal-and-or-lynch-related-cancer\/","title":{"rendered":"Family history of colorectal and\/or Lynch -related cancer"},"content":{"rendered":"
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Referrals are triaged by the Clinical Genetics team. Depending on the family history an assessment may be completed by letter or appointment.<\/p>\n\n<\/div>\n\n\n

If appropriate, a referral for colonoscopy screening will be made by Clinical Genetics.<\/p>\n\n\n\n

Please note that not all referrals will be allocated an appointment with Clinical Genetics.<\/p>\n\n\n\n

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Patients with a family history but no personal history of colorectal cancer<\/strong><\/h2>
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Patients who have not had cancer but report a family history of cancer should be directed to complete our family history questionnaire (details below) if they meet any of the family history criteria detailed in the table below.<\/strong> <\/p>\n\n\n\n

In addition;<\/p>\n\n\n\n

\u00b7 The patient being referred must have an affected first-degree <\/strong>relative.<\/p>\n\n\n\n

\u00b7 All affected relatives must be on the same side of the family.<\/p>\n\n\n\n

\u00b7 They must have at least one<\/strong> of the following:-<\/p>\n\n\n\n

Number of relatives affected with colorectal cancer<\/strong><\/td>Family History<\/strong><\/td><\/tr>
1 relative<\/td>1 first degree relative* with colorectal cancer diagnosed <50 years<\/td><\/tr>
2 relatives<\/td>2 first degree relatives with colorectal cancer diagnosed at any age in first degree kinship 1 first degree & 1 second degree relative (in a first degree kinship) diagnosed with CRC at any age<\/td><\/tr>
3 or more relatives<\/td>3 affected first degree relatives (in a first degree kinship) with colorectal cancer diagnosed at any age<\/td><\/tr><\/tbody><\/table>
If there is a known colorectal cancer predisposition syndrome in the family e.g. Lynch syndrome (HNPCC), Familial Adenomatous Polyposis (FAP), MYH Associated Polyposis (MAP), Peutz-Jeghers (PJS) patients can be referred for risk assessment\/consideration of predictive genetic testing\/risk management options.<\/strong><\/em>
*First degree relatives: parent, sibling, child
Second degree relatives: grandparent, aunt\/uncle, grandchild, niece\/nephew<\/figcaption><\/figure>\n\n\n\n

Patients with a family history that does not meet any of the above criteria are considered low risk and are eligible for the National Bowel Screening Programme from 50 years.<\/p>\n<\/div><\/div>\n\n<\/div>\n<\/div>\n\n\n

Patients who have had colorectal cance<\/strong>r.<\/h2>
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In order to meet the criteria for consideration of genetic testing patients must meet one of the following criteria<\/p>\n\n\n\n

\u2022 Diagnosed with CRC <45yrs (irrespective of MMR status of tumour)<\/p>\n\n\n\n

\u2022 Diagnosed with CRC\/Lynch-related cancer* any age & family history meets modified Amsterdam criteria** (irrespective of the MMR status of the tumour)<\/p>\n\n\n\n

\u2022 Diagnosed with dMMR tumour <70 yrs where results of IHC, BRAF &\/or MLH1 hypermethylation testing suggest LS<\/p>\n\n\n\n

\u2022 Has had another primary Lynch Syndrome associated cancer* (double primary)<\/p>\n\n\n\n

\u2022 You suspect patient may be clinically affected with a known syndrome e.g. PJS, JPS, SPS, FAP<\/p>\n\n\n\n

\u2022 Diagnosed with colorectal cancer <60yrs with \u22655 polyps<\/p>\n\n\n\n

\u2022 Patient with cancer and Wimmer score > 3<\/p>\n\n\n\n

\u2022 Scoring system for Constitutional Mismatch Repair Deficiency syndrome (CMMRD)<\/p>\n\n\n\n

\u2022 Distinct childhood cancer predisposition syndrome: GI, brain, haematological<\/p>\n\n\n\n

*Lynch-related cancers include but are not restricted to: Colorectal, Endometrial, Endocervical, Epithelial ovarian, Urothelial (urethra, bladder TCC, ureters, renal pelvis), Pancreatic, Bile duct (cholangiocarcinoma), Prostate, Small bowel, Brain (Glioblastoma), Skin (Multiple sebaceous tumours)<\/em><\/p>\n\n\n\n

** \u2265 3 cases of Lynch-related cancer over \u22652 generations with \u22651 case diagnosed \u226450 years<\/em><\/p>\n<\/div><\/div>\n\n\n

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Patients who have had colorectal polyps<\/strong>.<\/h2>
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In order to be eligible for genetic testing patients must meet one of the following criteria.<\/p>\n\n\n\n

\u2022 \u22655 adenomatous polyps & colorectal cancer (<60 yrs) OR<\/p>\n\n\n\n

\u2022 \u22655 adenomatous polyps (age <40 yrs), OR<\/p>\n\n\n\n

\u2022 \u226510 adenomatous polyps (age <60 yrs), OR<\/p>\n\n\n\n

\u2022 \u226520 adenomatous polyps (age \u2265 60 years), OR<\/p>\n\n\n\n

\u2022 \u22655 adenomatous polyps (age <60 yrs) AND first degree relative with \u22655 adenomatous polyps OR CRC (age <60 yrs), OR<\/p>\n\n\n\n

\u2022 \u226510 adenomatous polyps (age \u2265 60 yrs) AND first degree relative with \u22655 adenomatous polyps OR CRC (age <60 yrs)<\/p>\n\n\n\n

\u2022 Meets WHO diagnostic criteria for Serrated Polyposis Syndrome<\/p>\n\n\n\n

\u2022 Suspect patient may be clinically affected with a known syndrome e.g. PJS, JPS, SPS, FAP<\/p>\n\n\n\n

Small hyperplastic rectal polyps should not be included in the count & polyps should be histologically confirmed where possible.<\/em><\/p>\n\n\n\n

Testing may be considered for unusual\/large polyps occurring at a young age<\/em><\/p>\n<\/div><\/div>\n\n\n\n

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Scottish Genetic test directory<\/strong><\/p>\n\n\n\n

The current eligibility criteria for genetic testing for patients who have had CRC and\/or multiple polyps can be checked in the Scottish SSNGM Rare & Inherited Disease Test directory<\/a> (Hereditary Colorectal Cancer, Polyposis and Lynch Syndrome section)<\/p>\n","protected":false},"excerpt":{"rendered":"

Referrals are triaged by the Clinical Genetics team. Depending on the family history an assessment may be completed by letter or appointment. If appropriate, a referral for colonoscopy screening will be made by Clinical Genetics. Please note that not all referrals will be allocated an appointment with Clinical Genetics. Scottish Genetic test directory The current<\/p>\n","protected":false},"author":283,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-1331","page","type-page","status-publish","hentry"],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"philipgreene","author_link":"https:\/\/services.nhslothian.scot\/geneticservice\/author\/philipgreene\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Referrals are triaged by the Clinical Genetics team. Depending on the family history an assessment may be completed by letter or appointment. If appropriate, a referral for colonoscopy screening will be made by Clinical Genetics. Please note that not all referrals will be allocated an appointment with Clinical Genetics. Scottish Genetic test directory The current","_links":{"self":[{"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/pages\/1331","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/users\/283"}],"replies":[{"embeddable":true,"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/comments?post=1331"}],"version-history":[{"count":7,"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/pages\/1331\/revisions"}],"predecessor-version":[{"id":1341,"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/pages\/1331\/revisions\/1341"}],"wp:attachment":[{"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/media?parent=1331"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/services.nhslothian.scot\/geneticservice\/wp-json\/wp\/v2\/categories?post=1331"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}