Gynecologic cancers in Lynch syndrome/HNPCC

Recent studies have estimated that the lifetime risk of endometrial cancer in women with Lynch syndrome/hereditary non-polyposis colorectal cancer syndrome (Lynch/HNPCC) is 40-60%. This risk equals or exceeds their risk for colon cancer. While much research has been done to define the natural history and molecular features of Lynch/HNPCC associated colon cancer, there has been considerably less research defining Lynch/HNPCC associated endometrial cancer. This article will review current information regarding the clinico-pathologic features of Lynch/HNPCC associated endometrial cancer. In addition, current consensus guidelines for endometrial cancer screening and prevention for women with Lynch/HNPCC will be discussed. Given the increased risk of multiple cancers, changing the name of this syndrome from hereditary non-polyposis colorectal cancer syndrome to Lynch Syndrome may benefit both patients and clinicians. Clinicians caring for women with Lynch/HNPCC may stress colon cancer screening and prevention without reviewing endometrial cancer risks and symptoms or screening and prevention options. Perhaps more importantly, women with Lynch/HNPCC may focus on colon cancer risks and lack understanding of endometrial cancer risks. With increasing evidence that women with Lynch/HNPCC have significant risks for both colon and endometrial cancers, we believe a multi-disciplinary approach to the management of these individuals is crucial.