Table 3.

Amsterdam Criteria and Revised Bethesda Guidelines

Amsterdam Criteria I

At least three relatives with CRC; all of the following must be met: One affected individual is a first degree relative of the other two At least two successive generations affected At least one CRC diagnosed before the age of 50 years Familial adenomatous polyposis has been excluded

Amsterdam Criteria II

At least three relatives with colorectal, endometrial, small bowel, ureter, or renal pelvis cancer; all of the following must be met: One affected individual is a first degree relative of the other two At least two successive generations affected At least one tumor diagnosed before the age of 50 years Familial adenomatous polyposis has been excluded

Revised Bethesda Guidelines

Requires at least one of the following: CRC diagnosed in a patient who is less than 50 years of age Presence of synchronous, metachronous CRC, or other LS-associated tumora, regardless of age CRC diagnosed in a patient who is less than 60 years of age with MSI-H histologyb CRC diagnosed in an individual and one or more first degree relatives with an LS-associated tumora, with at least one of the cancers being diagnosed under age 50 years CRC diagnosed in an individual and two or more first or second degree relatives with LS-associated tumorsa, regardless of age

CRC, Colorectal cancer; LS, Lynch syndrome; MSI-H, Microsatellite instability high

^aEndometrial, stomach, ovarian, pancreas, ureter, and renal pelvis, biliary tract, and brain tumors, sebaceous gland adenomas and keratoacanthomas, and carcinoma of the small bowel

^bTumor infiltrating lymphocytes, Crohn’s-like lymphocytic reaction, mucinous/signet-ring differentiation, or medullary growth pattern