- Title
- Dominantly inherited micro-satellite instable cancer - the four Lynch syndromes - an EHTG, PLSD position statement.
- Creator
- Møller, Pal; Seppälä, Toni T.; Kohut, Kelly E.; Ryan, Neil; Bauerfeind, Peter; Thomas, Laura E.; Evans, D. Gareth; Aretz, Stefan; Sijmons, Rolf H.; Half, Elizabeth; Heinimann, Karl; Horisberger, Karoline; Ahadova, Aysel; Monahan, Kevin; .,; Crosbie, Emma J.; Holinski-Feder, Elke; Scott, Rodney; Haupt, Saskia; Möslein, Gabriela; Winship, Ingrid; Bajwa-ten Broeke, Sanne W.
- Relation
- Hereditary Cancer in Clinical Practice Vol. 21, Issue 1, no. 19
- Publisher Link
- http://dx.doi.org/10.1186/s13053-023-00263-3
- Publisher
- BioMed Central
- Resource Type
- journal article
- Date
- 2023
- Description
- The recognition of dominantly inherited micro-satellite instable (MSI) cancers caused by pathogenic variants in one of the four mismatch repair (MMR) genes MSH2, MLH1, MSH6 and PMS2 has modified our understanding of carcinogenesis. Inherited loss of function variants in each of these MMR genes cause four dominantly inherited cancer syndromes with different penetrance and expressivities: the four Lynch syndromes. No person has an "average sex "or a pathogenic variant in an "average Lynch syndrome gene" and results that are not stratified by gene and sex will be valid for no one. Carcinogenesis may be a linear process from increased cellular division to localized cancer to metastasis. In addition, in the Lynch syndromes (LS) we now recognize a dynamic balance between two stochastic processes: MSI producing abnormal cells, and the host's adaptive immune system's ability to remove them. The latter may explain why colonoscopy surveillance does not reduce the incidence of colorectal cancer in LS, while it may improve the prognosis. Most early onset colon, endometrial and ovarian cancers in LS are now cured and most cancer related deaths are after subsequent cancers in other organs. Aspirin reduces the incidence of colorectal and other cancers in LS. Immunotherapy increases the host immune system's capability to destroy MSI cancers. Colonoscopy surveillance, aspirin prevention and immunotherapy represent major steps forward in personalized precision medicine to prevent and cure inherited MSI cancer.
- Subject
- acetylsalicylic acid; DNA mismatch repair protein MSH2; mismatch repair protein PMS2; MutL protein homolog 1; protein MSH6; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1495030
- Identifier
- uon:53958
- Identifier
- ISSN:1731-2302
- Rights
- © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
- Language
- eng
- Full Text
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