1.0.0.0 Rec­om­men­da­tions and GRADE

1.1.0.0 Rec­om­men­da­tions

Sr.­no.

Recommendations

SoR

QoE

1

In patients without a personal history of colorectal or another cancer but with a family history suggestive of Lynch syndrome, the AGA suggests that risk prediction models be offered rather than doing nothing.

Cond

V Low

Evidence for Recommendation 1

2

In patients without a personal history of colorectal or another cancer but with a family history suggestive of Lynch syndrome, the AGA suggests that risk prediction models be offered rather than proceeding directly with germline genetic testing.

Cond

V Low

Evidence for Recommendation 2

3

The AGA recommends testing the tumors of all patients with colorectal cancer with either immunohistochemistry (IHC) or for microsatellite instability (MSI) to identify potential cases of Lynch syndrome versus doing no testing for Lynch syndrome.

Strong

Mod

Evidence for Recommendation 3

4

The AGA suggests that in patients with colorectal cancer with IHC absent for MLH1, second-stage tumor testing for a BRAF mutation or for hypermethylation of the MLH1 promoter should be performed rather than proceeding directly to germline genetic testing.

Cond

V Low

Evidence for Recommendation 4

5

The AGA recommends surveillance colonoscopy (versus doing nothing) in persons with Lynch syndrome.

Strong

Mod

Evidence for Recommendation 5

6

The AGA suggests that surveillance colonoscopy should be performed every 1 to 2 years versus less frequent intervals.

Cond

Low

Evidence for Recommendation 6

7

The AGA suggests that aspirin be offered for cancer prevention in patients with Lynch syndrome.

Cond

Low

Evidence for Recommendation 7

SoR: Strength of Recommendation
QoE: Quality of Evidence
Strong: Strong Recommendation
Cond: Conditional Recommendation
High: High-Quality Evidence
Mod: Moderate-Quality Evidence
Low: Low-Quality Evidence
V Low: Very Low-Quality Evidence