According to the Amsterdam II criteria for hereditary non-polyposis colorectal cancer (Lynch syndrome), which of the following is NOT required?

• A At least three relatives with Lynch syndrome-associated cancers (colorectal, endometrial, small bowel, ureter/renal pelvis)
• B Microsatellite instability testing positive in the tumor ✓
• C At least two successive generations affected
• D One relative diagnosed before age 50 years

Explanation

Amsterdam II criteria are purely clinical (family history-based) and do not require molecular testing. They mandate: ≥3 relatives with Lynch-associated cancers, ≥2 successive generations, ≥1 relative diagnosed before age 50, and FAP excluded. MSI testing (part of the Bethesda/revised Bethesda guidelines) is used for screening/confirming Lynch syndrome but is not part of the Amsterdam II diagnostic criteria itself.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.