Table 2.

LS screening pathways.

Country	Inclusion criteria	Screening pathway and methodologies	Healthcare professionals involved	Number of patients screened	LS carriers detected	LS detection rate (%)
Ohio (USA)	Universal CRC screening	(1)MSI test or IHC (2)BRAF test if MLH1 loss	Pathologist	784	17	2.2
		(3)Genetic counseling recommendation	Colorectal surgeon
		(4)Genetic counseling and germline testing	Genetic counselor
West Australia	CRC with any of the following: ➢<60 years ➢Individual or family history of cancer	(1)IHC (2)MSI test for confirmation (3)BRAF test if MSI+ and MLH1 loss and/or PMS2 expression	Pathologist	NR	42	NR
		(4)Genetic counseling recommendation	Treating clinician
	➢Histological characteristics	(5)Genetic counseling and germline testing	NR
California (USA)	CRC with any of the following: ➢≤50 years	(1)IHC (2)BRAF test if MLH1 loss	Pathologist	57	3	5.3
	➢Histological characteristics	(3) Genetic counseling recommendation	Treating clinician or multidisciplinary team
	➢Synchronous CRC	(4) Genetic counseling and germline testing	Genetic counselor
Washington (USA)	Universal CRC screening	(1)MSI test or IHC, or MSI test + IHC (2)BRAF test if MLH1 loss or MSI-high	Pathologist	31	0	0
		(3)Genetic counseling recommendation	Multidisciplinary team
		(4)Genetic counseling and germline testing	Genetic counselor
Switzerland	Universal CRC screening	(1)IHC (2)BRAF test (or IHC) if MLH1 loss	Pathologist	486	4	0.8
		(3)Genetic counseling recommendation	Multidisciplinary team
		(4)Genetic counseling and germline testing	Geneticist

NR, not reported; CRC, colorectal cancer; IHC, immunohistochemistry; LS, Lynch syndrome; MSI, microsatellite instability.