{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:21:22Z","timestamp":1790623282311,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Colorectal cancer (<jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>) is diagnosed in approximately 45\u00a0000 people annually in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>, and it is estimated that Lynch syndrome (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>) accounts for 3.1% of these cases. In February 2017, National Institute for Health and Care Excellence (<jats:styled-content style=\"fixed-case\">NICE<\/jats:styled-content> guideline <jats:styled-content style=\"fixed-case\">DG<\/jats:styled-content>27 recommended universal testing of new cases of <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> for mismatch repair (<jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content>) status. The aim of this study was to implement universal testing for LS in CRC patients in a secondary care setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We prospectively collected data on consecutive newly diagnosed <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> patients at our centre from November 2016 to August 2018, including evidence of <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> status determined by immunohistochemistry. We recorded clinicopathological data including age at diagnosis, stage, tumour site, reported histological findings and <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> tumour status. Statistical analysis was performed using the chi\u2010square test and the two\u2010tailed <jats:italic>t<\/jats:italic>\u2010test for binary and continuous variables, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cohort of 203 consecutive patients were diagnosed with <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> during this period. Universal <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> testing was performed for the 198 <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content> patients in whom a diagnosis of adenocarcinoma was confirmed, with colonoscopic biopsy used as the source material in 68.6% of cases. Twenty\u2010three <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>s (11.6%) were <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> deficient (<jats:styled-content style=\"fixed-case\">dMMR<\/jats:styled-content>). Most <jats:styled-content style=\"fixed-case\">dMMR CRC<\/jats:styled-content>s (21\/23) were early stage tumours (Dukes A or B, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). In 39 Dukes B <jats:styled-content style=\"fixed-case\">CRC<\/jats:styled-content>s in patients under 70\u00a0years of age, the result of <jats:styled-content style=\"fixed-case\">MMR<\/jats:styled-content> testing influenced decision\u2010making about personalized treatment with 5\u2010fluorouracil based chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results demonstrate that universal testing of all new cases of CRC for features suggestive of <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> is feasible and effective in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>. Our data also indicate the importance of genetic testing and personalized oncological care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14597","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T08:19:41Z","timestamp":1551341981000},"page":"760-766","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Experience of the implementation and outcomes of universal testing for Lynch syndrome in the United Kingdom"],"prefix":"10.1111","volume":"21","author":[{"given":"A.","family":"Cavazza","sequence":"first","affiliation":[{"name":"Imperial College London and The Family History of Bowel Cancer Clinic Department of Gastroenterology West Middlesex University Hospital Chelsea and Westminster Hospitals NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Radia","sequence":"additional","affiliation":[{"name":"Imperial College London and The Family History of Bowel Cancer Clinic Department of Gastroenterology West Middlesex University Hospital Chelsea and Westminster Hospitals NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Harlow","sequence":"additional","affiliation":[{"name":"Imperial College London and The Family History of Bowel Cancer Clinic Department of Gastroenterology West Middlesex University Hospital Chelsea and Westminster Hospitals NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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