Key Takeaways
- Genotype-informed surveillance should pair colonoscopy with upper endoscopy when MLH1/MSH2 mutations or family history elevate gastric cancer risk.
- Finding benign polyps during routine scopes validates intensified screening in Lynch syndrome, shifting detection upstream before malignant transformation and reducing preventable mortality.
- Prep tolerability improves with pre-prep dietary lightening, chilled split-dose solutions, straw use, permitted clear-liquid chasers, aggressive hydration, and broth to support IV access.
- Risk management extends beyond endoscopy to anxiety coping, certified genetic counseling, early-age initiation of colonoscopy (often 20s or 10 years pre-index case), and individualized aspirin chemoprevention discussions.
Lynch Syndrome Ireland 