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Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome) in Argentina: Report from a Referral Hospital Register

Vaccaro, Carlos A. M.D.; Bonadeo, Fernando M.D.; Roverano, Analía V. M.D.; Peltomaki, Paivi M.D.; Bala, Shashi Ph.D.; Renkonen, Elise Ph.D.; Redal, Maria A. Ph.D.; Mocetti, Esteban M.D.; Mullen, Eduardo M.D.; Ojea-Quintana, Guillermo M.D.; Benati, Mario L. M.D.; Rivello, Hernan Garcia M.D.; Clark, Mary B. M.S.W.; Lynch, Jane F. B.S.N.; Lynch, Henry T. M.D.
Diseases of the Colon & Rectum: October 2007
doi: 10.1007/s10350-007-9037-y
Original Contributions: PDF Only

Purpose: Purpose:The first Argentine experience with epidemiologic, molecular, and genetic counseling data is reported.

Methods: Methods:We analyzed 43 families fulfilling Amsterdam criteria identified from a prospective database with data from 779 relatives.

Results: Results:Eleven families (25.6 percent) presented as Lynch I, 29 (67.4 percent) as Lynch II, and 3 (7 percent) as Muir-Torre syndrome. Among the 306 affected members, 197 cases of colorectal cancer were identified (mean age at diagnosis, 52.1 (range, 21-90) years). The most frequent extracolonic tumors were gastric adenocarcinoma in males and endometrium adenocarcinoma in females. A high incidence of breast cancer was observed (16 cases among 155 females, crude rate: 11,594.20/100,000). Twenty-seven patients (8.8 percent) developed more than one tumor. These patients were younger than those with only one tumor (45vs.51 years;P= 0.001). In 5 of 11 patients who underwent molecular sequencing, a pathologic mutation was found. A novel C deletion at 1910 nucleotide, codon 637, exon 12 of MSH2 gene was identified in a family with a strong aggregation of breast cancer with lack of MSH2 immunohistochemical staining. For 78.2 percent of counseled individuals, this session represented the first time they received information, and 73.9 percent stated that their physicians were unaware of their family background.

Conclusions: Conclusions:Argentine families presented a high incidence of stomach cancer. The elevated incidence of breast cancer and its association with a novelhMSH2mutation bring to consideration the inclusion of this malignancy as part of the syndrome. A lack of awareness by both physicians and persons at risk was observed.

Poster presentation at the meeting of the Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA-ICC), Salt Lake City, Utah, October 23-24, 2005.

e-mail: carlos.vaccaro@hospitalitaliano.org.ar

© The ASCRS 2007