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Prophylactic Surgery Reduces Risk of Gynecologic Cancers in Women With Lynch Syndrome

Prophylactic Surgery Reduces Risk of Gynecologic Cancers in Women With Lynch Syndrome

Creighton Research Published in New England Journal of Medicine

Women who carry a gene mutation for a form of hereditary colon cancer, called the Lynch syndrome, may consider having gynecologic surgery to prevent the risk of cancer of the ovary and of the uterus, according to Creighton University hereditary cancer expert and medical oncologist, Henry T. Lynch, M.D., in an article which appears in the New England Journal of Medicine.

Women with the Lynch syndrome (hereditary nonpolyposis colorectal cancer) have a 40 to 60 percent lifetime risk of endometrial cancer and a 10 to 12 percent lifetime risk of ovarian cancer.

Lynch and his colleagues at Creighton University, University of Texas M.D. Anderson Cancer Center and University of California at San Francisco, studied 315 women with the germ-line mutations for the Lynch syndrome to determine if prophylactic, or preventive, gynecologic surgery reduced the risk of developing cancer.

They found that among the control group (no surgery), 33 percent developed endometrial cancer and 5 percent developed ovarian cancer. However, among the women who had undergone prophylactic surgery, there were no occurrences of endrometrial, ovarian or primary peritoneal cancer.

The researchers concluded that for women with the Lynch syndrome, prophylactic removal of the uterus, ovaries and fallopian tubes is an effective strategy for preventing endometrial and ovarian cancer.

Since the early 1960s, when he described the Lynch syndrome, and from the mid 1970s on, Dr. Lynch has been promoting the need to consider the option of prophylactic hysterectomy and bilateral oophorectomy (removal of the ovaries) as a management option for high risk patients who have completed their childbearing.

“Now that we have gathered the largest database of Lynch syndrome families, we are able to assemble pertinent data that can be used by gynecologists and gynecological oncologists in preventing the incidence of cancer in their high-risk patients,” said Dr. Lynch. “Prophylactic surgery is one option in the tool chest, which has now been shown to have significant results in reducing risk of gynecological cancer.”

Dr. Lynch is professor of medicine, chairman of Preventive Medicine at Creighton University and the holder of the Charles F. and Mary C. Heider Endowed Chair in Cancer Research.

Posted: 1/20/06