Initiation of universal tumor screening for Lynch syndrome in colorectal cancer patients as a model for the implementation of genetic information into clinical oncology practice

摘要: BACKGROUND Lynch syndrome confers a hereditary predisposition to colorectal and other cancers. Universal tumor screening (UTS) for Lynch is recommended by several professional societies, but the implementation can be complex. This article describes evaluation, process development, initiation of UTS at tertiary referral cancer center. METHODS A multidisciplinary team developed new design. Issues in 5 themes were noted: timing, funding, second-opinion patients, result processing, role genetics providers. A committee approach was used examine each issue process-improvement development. RESULTS The issues related testing addressed individually successful institutional level. In conventional-care period, 9 30 cases (30%) received screening, 4 referred medical genetics. During 6 months following UTS, 32 44 patients (73%) screening. The 13 unscreened all had identified reasons nonscreening (eg, financial limitations). Ten genetics, which no syndrome, low-risk adenomatous polyposis coli (APC) variant detected 1 individual. CONCLUSIONS The effective feasibly alter practice experience with assessment management relevant clinical care paradigm based on emerging technology has implications uptake advances across molecular oncology into practice, this highly current era rapidly evolving genomic technology. Cancer 2016;122:393–401. © 2015 American Society.