A 40-year-old woman with known Lynch syndrome (MSH2 mutation carrier) is undergoing surveillance for endometrial carcinoma. According to current guidelines, at what age should annual endometrial biopsy screening be initiated in Lynch syndrome?
- A From age 25 years
- B From age 45 years
- C From age 30-35 years ✓
- D Only when symptomatic with abnormal bleeding
Correct answer: C. From age 30-35 years
Explanation
NCCN and major gynaecological oncology guidelines recommend annual endometrial biopsy screening starting at age 30-35 years in women with Lynch syndrome (HNPCC), as endometrial cancer is the sentinel cancer in 50% of female carriers. Screening from age 25 is recommended for some colorectal surveillance but not for endometrial. Waiting until age 45 or until symptomatic misses the window for early detection, as Lynch-associated endometrial cancers occur at a younger mean age than sporadic cases.
Reference: Williams Gynecology, 4th ed.
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Written and medically reviewed by the StethoPrep medical team.