Table 5.

Bethesda Guidelines

1. Individuals in families that meet the Amsterdam criteria.

2. Individuals with 2 hereditary nonpolyposis colon cancer (HNPCC)-related cancers, including synchronous and metachronous colorectal cancers or associated extracolonic cancers (endometrial, ovarian, gastric, hepatobiliary, or small bowel carcinomas or transitional cell carcinoma of the ureter or renal pelvis).

3. Individuals with colorectal cancer and a first-degree relative with colorectal cancer and/or HNPCC-related extracolonic cancer and/or a colorectal adenoma; 1 of the cancers diagnosed at age < 45 years, and the adenoma diagnosed at age < 40 years.

4. Individuals with colorectal or endometrial cancer diagnosed at age < 45 years.

5. Individuals with a signet-ring cell colorectal cancer (composed of > 50% signet ring cells) diagnosed at age < 45 years.

6. Individuals with a right-sided colorectal cancer with an undifferentiated pattern on histology (poorly or undifferentiated carcinoma composed of irregular, solid sheets of large eosinophilic cells and containing small gland-like spaces) diagnosed at age < 45 years.

7. Individuals with adenomas diagnosed at age < 40 years.