European guidelines from the EHTG and ESCP for Lynch syndrome: an updated third edition of the Mallorca guidelines based on gene and gender
EHTG/ESCP · 2021 · Europe
Source and licence
- Authors
- T T Seppälä, A Latchford, I Negoi et al.
- Title
- European guidelines from the EHTG and ESCP for Lynch syndrome: an updated third edition of the Mallorca guidelines based on gene and gender
- Journal
- The British Journal of Surgery, 2021
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC10364896
Licence statement of the original publication
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Background: Lynch syndrome is the most common genetic predisposition for hereditary cancer but remains underdiagnosed. Large prospective observational studies have recently increased understanding of the effectiveness of colonoscopic surveillance and the heterogeneity of cancer risk between genotypes. The need for gene‐ and gender‐specific guidelines has been acknowledged.
Methods: The European Hereditary Tumour Group (EHTG) and European Society of Coloproctology (ESCP) developed a multidisciplinary working group consisting of surgeons, clinical and molecular geneticists, pathologists, epidemiologists, gastroenterologists, and patient representation to conduct a graded evidence review. The previous Mallorca guideline format was used to revise the clinical guidance. Consensus for the guidance statements was acquired by three Delphi voting rounds.
Results: Recommendations for clinical and molecular identification of Lynch syndrome, surgical and endoscopic management of Lynch syndrome‐associated colorectal cancer, and preventive measures for cancer were produced. The emphasis was on surgical and gastroenterological aspects of the cancer spectrum. Manchester consensus guidelines for gynaecological management were endorsed. Executive and layperson summaries were provided.
Conclusion: The recommendations from the EHTG and ESCP for identification of patients with Lynch syndrome, colorectal surveillance, surgical management of colorectal cancer, lifestyle and chemoprevention in Lynch syndrome that reached a consensus (at least 80 per cent) are presented.
Contents of the original publication
The section headings of the original.
- Definitions used in these guidelines
- Executive summary of recommendations
- General information
- Identification of carriers
- Surveillance for colorectal cancer
- Surveillance, management and prevention of gynaecological cancer
- Surgical management of colorectal cancer
- Lifestyle and chemoprevention
- Introduction
- Methods
- Guideline group
- Scope of updated guidelines
- Literature search
- Timeline and meetings
- Question 1: how can the identification of Lynch syndrome be improved?
- Conclusions and recommendations
- Question 2: what is the optimal colorectal surveillance protocol for Lynch syndrome?
- Subquestion 1: should colonoscopic surveillance be performed?
- Subquestion 2: should chromoendoscopy/virtual chromoendoscopy be performed?
- Subquestion 3: what is the appropriate colonoscopic surveillance interval?
- Subquestion 4: at what age should surveillance colonoscopy be initiated?
- Question 3: what is the effectiveness of surveillance for other cancers?
- Conclusions and recommendations
- Question 4: what is the appropriate surgical treatment for colorectal cancer?
- Subquestion 1: should extended surgery for Lynch syndrome‐associated colonic cancer be recommended?
- Subquestion 2: how should surgery for rectal cancer in Lynch syndrome be performed?
- Subquestion 3: should prophylactic bowel surgery be performed?
- Question 5: what is the influence of lifestyle factors on the development of adenoma or colorectal cancer in Lynch syndrome?
- Conclusions and recommendations
- Question 6: what is the role of acetylsalicylic acid (aspirin) in the management of Lynch syndrome?
- Conclusions and recommendations
- Final conclusion
- Supporting information
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