When a parent has Lynch syndrome or carries a genetic alteration in one of their related genes, there is a 50 percent chance that each of their children will inherit the altered gene and also have Lynch syndrome. People who test positive for Lynch syndrome should have colonoscopies starting at age 20 to 25, and an upper endoscopy every three to five years beginning at age 30 to 35. Women are encouraged to be screened for endometrial cancers every 1 to 2 years beginning at age 30. Currently, there is no effective screening for ovarian cancer, so it’s important for women with Lynch syndrome to familiarize themselves with potential symptoms of ovarian cancer. Sometimes a transvaginal ultrasound is used as an adjunct screening for ovarian cancer but it is not very sensitive. Women with Lynch syndrome should also give strong consideration to a prophylactic hysterectomy with bilateral oophorectomy, or the removal of ovaries, once childbearing is complete. Both men and women should undergo an annual urinalysis and neurological exams beginning at age 25 to 30 and an annual physical exam that includes a full skin exam to look for malignant and benign skin manifestations. Low-dose aspirin is also recommended for colorectal cancer prevention, according to the ASCO. Pancreatic cancer screening should begin at age 40 with yearly magnetic resonance imaging scans (MRIs) or magnetic resonance cholangiopancreatography (MRCP) scans.
