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Universal screening of colorectal cancers (CRCs) for Lynch Syndrome (LS) is advocated by several professional societies. However, previous studies have shown that the yield and cost-effectiveness of screening are significantly decreased in the elderly.
In this retrospective cohort study, investigators assessed the performance of LS screening at different upper age cutoffs in nearly 3900 patients with newly diagnosed CRC in a large healthcare system. Tumors were screened using immunohistochemistry (IHC) for mutation mismatch repair protein expression (MLH1, MSH2, MSH6, and PMS2). The results were as follows:
Of 63 LS cases identified, 58 were diagnosed at age ≤70 years.
A screening upper age limit of 70 would have missed 5 LS cases but resulted…