Table 2.

Recommendations for cancer surveillance in Lynch syndrome.

Cancer Type	MLH1	MSH2	MSH6	PMS2
Colorectal cancer	Colonoscopy every 1–2 years, starting at 20–25 y	Colonoscopy every 1–2 years, starting at 20–25 y	Colonoscopy every 1–3 years, starting at 30–35 y	Colonoscopy every 1–3 years, starting at 30–35 y
Endometrial and ovarian cancers *	Pelvic ultrasound and/or endometrial biopsy every 1–2 years, starting at 30–35 y	Pelvic ultrasound and/or endometrial biopsy every 1–2 years, starting at 30–35 y	Pelvic ultrasound and/or endometrial biopsy every 1–2 years, starting at 30–35 y	Pelvic ultrasound and/or endometrial biopsy every 1–2 years, starting at 30–35 y
Ureteral cancer	Urinalysis, urine cytology, and abdominal ultrasound every 1–2 years, starting at 40–45 y	Urinalysis, urine cytology, and abdominal ultrasound every 1–2 years, starting at 40–45 y	Urinalysis, urine cytology, and abdominal ultrasound every 1–2 years, starting at 40–45 y	Urinalysis, urine cytology, and abdominal ultrasound every 1–2 years, starting at 40–45 y
Gastric and duodenal cancers	EGD every 3–5 years, starting at 30–35 y	EGD every 3–5 years, starting at 30–35 y	EGD every 3–5 years, starting at 30–35 y	EGD every 3–5 years, starting at 30–35 y

EGD: esophagogastroduodenoscopy. * Risk-reducing surgical treatment in the form of total hysterectomy and bilateral salpingo-oophorectomy should be offered from ages 35 to 40 years, or after completion of childbearing.