Introduction Female carriers of the Lynch syndrome (LS) have an increased risk to develop endometrial cancer (EC). Dutch guidelines advise annual gynecological examination between age 40 and 60. It is hitherto unclear to what extent gynecological screening in this population contributes to earlier detection of EC. Therefore, screening outcomes were assessed in a nationwide cohort of LS carriers.

Methods This retrospective cohort study used data from molecularly proven LS carriers included in a prospectively maintained, national, voluntary database. Data were linked to the Dutch National Pathology Registry to assess EC development. Enrollment in a gynecological surveillance program, EC stage, and cause of death were obtained in corresponding patients’ medical files.

Results Of 1255 female LS carriers registered in the Dutch LS database, 20.4% (n=256) was not yet eligible for surveillance. Of eligible women, 44.5% (n=558) was enrolled in gynecological surveillance (surveillance group), and 35% (n=441) had no surveillance whatsoever (no surveillance group). In the surveillance group, 18.3% (n=102) developed EC, of which 52% (n=53) in stage I/II versus 42.2% (n=43) in stage III/IV. For 5.9% (n=6), stage was unknown. In the no surveillance group, 16.8% (n=74) developed EC, of which 47.3% (n=35) in stage I/II versus 48.6% (n=36) in stage III/IV, and 4.0% unknown (n=3). In each group, two carriers died from EC.

Conclusion/Implications Gynecological surveillance complying with Dutch guidelines did not seem to cause much earlier EC detection and did not seem to have an effect on death due to EC in female LS carriers.