Introduction/Background Mismatch Repair (MMR) testing for endometrial cancer (EC) patients was recommended by the National Institute for Health and Care Excellence (NICE) October 2020 guidance as a screening tool for Lynch syndrome (LS). The North-East of England regional cancer care alliance implemented this guidance in aims to identify EC patients with suspected LS. This project evaluated the efficacy of MMR screening model via immunohistochemistry (IHC) testing for the MMR markers: MLH1, PMS2, MSH2, and MHS6 by reviewing our experience of implementing this MMR testing for LS screening in EC care.
Methodology Retrospective analysis of all newly diagnosed EC patients referred for Multi-Disciplinary Team review from six NHS trusts in the North-East of England and North Cumbria was performed, and we assessed the status and outcome of MMR testing in this cohort.
Results The status and outcome of MMR testing were collected and analysed in 202 patients, and it was shown that 97% (195) of the examined population had their MMR status reported. Approximately 73% of eligible patients for MMR testing were shown to be MMR-proficient and therefore did not require further testing. Using this screening model, at least 5% of the eligible EC patients were identified to be at risk for LS and needed referral to specialist clinical genetics service for germline testing.
Conclusion In the North-East of England region, MMR screening rate in EC remains over 95%, consistent with our pilot data from the screening project’s initial implementation period in 2021. The implementation of this screening model in the region has proven to be effective in identifying EC patients with suspected LS, supporting the importance of this screening model in EC care.
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