Natural history of colorectal cancer in hereditary nonpolyposis colorectal cancer (Lynch syndromes I and II)

Henry T. Lynch, Patrice Watson, Stephen J. Lanspa, Joseph Marcus, Tom Smyrk, Robert J. Fitzgibbons, Mary Kriegler, Jane F. Lynch

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Approximately 5 to 6 percent of the total colorectal cancer burden is accounted for by hereditary nonpolyposis colorectal cancer (HNPCC). Because clinical premonitory signs such as those seen in familial polyposis coli (FPC) are lacking, the clinician must recognize clinical findings and family history typical of HNPCC. The authors have described colorectal cancer expression from a survey of ten HNPCC kindreds. Kindred members with colorectal cancer differed significantly (P<.05) from patients with sporadic colorectal cancer: 1) mean age of initial colon cancer diagnosis was 44.6 years; 2) 72.3 percent of first colon cancers were located in the right colon, and only 25 percent were in the sigmoid colon and rectum; 3) 18.1 percent had synchronous colon cancers; and 4) 24.2 percent developed metachronous colon cancer, with a risk for metachronous lesions in ten years of 40 percent. Affecteds and their first-degree relatives should undergo early intensive education and surveillance. In families with an early age of onset, colonoscopy should begin at age 25, and biannually thereafter, with fecal occult blood testing of the stool semiannually. Third-party carriers must become more responsive to the costly surveillance measures required for these otherwise healthy patients.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalDiseases of the Colon & Rectum
Issue number6
StatePublished - Jun 1988


  • Hereditary cancer
  • Lynch syndromes I and II
  • Natural history
  • Nonpolyposis

ASJC Scopus subject areas

  • Gastroenterology


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