Figure 2.

Algorithm for genetic evaluation of individuals with colorectal cancer based on revised Bethesda guidelines and PREMM score. IHC, immunohistochemistry; MSI, microsatellite instability.*Other models may be used. Each model has its own prespecified cutoff (PREMM_1,2: http://www.dana-farber.org/pat/cancer/gastrointestinal/crc-calculator/default.asp; Barnetson: https://hnpccpredict.hgu.mrc.ac.uk/; MMR pro: http://astor.som.jhmi.edu/Bayes-Mendel/). ^†If loss of MLH1 expression, BRAF analysis should be performed. ^‡Surveillance recommendations based on personal and family history. From Grover S, Syngal S. Genetic testing in gastroenterology: Lynch syndrome. Best Pract Res Clin Gastroentrol 2009; 23:185–196. Reprinted with kind permission of Elsevier.