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Faculty

Richard Colling

Cellular Pathology, John Radcliffe Hospital,
Oxford University Hospitals NHS Trust,
Oxford, UK

David N Church

Oxford Cancer Centre, University of Oxford, Oxford, UK

Juliet Carmichael

Oxford Cancer Centre, University of Oxford, Oxford, UK

Lucinda Murphy

Department of Cellular Pathology,
Oxford University Hospitals NHS Trust, Oxford, UK

James East

Department of Gastroenterology,
Oxford University Hospitals NHS Trust, Oxford, UK

Peter Risby

Department of Genetics,
Oxford University Hospitals NHS Trust, Oxford, UK

Rachel Kerr

Oxford Cancer Centre, University of Oxford, Oxford, UK

Runjan Chetty

Department of Cellular Pathology,
Oxford University Hospitals,
Oxford Biomedical Research Centre,
University of Oxford, Oxford, UK

Lai Mun Wang

Cellular Pathology, John Radcliffe Hospital,
Oxford University Hospitals NHS Trust,
Oxford, UK

Accredited by

BMJ Learning

Course Description

Lynch syndrome (LS) accounts for around 3% of colorectal cancers (CRCs) and is caused by germline mutations in mismatch repair (MMR) genes. Recently, screening strategies to identify patients with LS have become popular. We audited CRCs screened with MMR immunohistochemistry (IHC) in 2013. 209 tumours had MMR IHC performed at a cost of £12 540. 47/209 (21%) cases showed IHC loss of expression in at least one MMR protein. 28/44 cases with loss of MLH1 had additional BRAF V600E testing, at a cost of £5040. MMR IHC reduced the number of potential clinical genetics referrals from 209 to 47. BRAF mutation testing, performed in a subset of cases with MLH1 loss, further reduced this to 21. At a cost of £1340 per referral, this model of LS screening for clinical genetics referral had significant potential savings (£234 340) and can be easily implemented in parallel with MMR IHC done for prognostication in CRCs.

Activity Details

Credit Types:CME
Credit Amount:1.00 Credits
Release Date:2015-Jul-08
Expiration Date:2017-Jul-08
Estimated Time for Completion:1 hour
Registration Required:Yes
Cost:£35.00-£99.00/yr

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