Impact of a Multidisciplinary Approach to Lynch Syndrome Management on Adherence to Gastrointestinal Screening...

The Geisinger Inherited Risk Gastrointestinal clinic (IRGI) offers annual multidisciplinary care to patients with Lynch syndrome (LS). Adherence to recommended colonoscopy and esophago-gastro-duodenoscopy (EGD) surveillance among IRGI patients with LS were compared with patients with LS not followed by IRGI (non-IRGI).

A validated query of electronic health record data was performed. Gene-specific guidelines were used to determine adherence to recommended surveillance following result disclosure until March 2025. For those who received results before 2016, adherence was assessed from April 2016 to March 2025. Pearson's chi-square, Fisher's exact, Wilcoxon rank-sum tests, and logistic regressions were performed to compare adherence to recommended surveillance between IRGI and non-IRGI patients.

A total of 548 patients with LS were included, of which 167 (30.5%) attended IRGI and 381 (69.5%) did not. Patients who were younger (odds ratio [OR], 1.03 [95% CI, 1.01 to 1.04]; P = .0002) or were identified via indication-based testing (OR, 9.69 [95% CI, 5.63 to 17.1], P < .0001) were more likely to be IRGI patients. For colonoscopy adherence among patients eligible for surveillance, 74.0% (94/127) of IRGI patients and 31.0% (97/313) of non-IRGI patients were adherent to all recommended postresult surveillance (P < .0001). For EGD adherence, 89.3% (50/56) of IRGI patients and 40.9% (61/149) of non-IRGI patients were adherent (P < .0001). Across the cohort, IRGI patients were more likely to be adherent to colonoscopy (OR, 7.40 [95% CI, 4.07 to 14.0], P < .0001) and EGD (OR, 7.32 [95% CI, 2.92 to 21.2], P < .0001).

Attending IRGI was associated with higher adherence to surveillance guidelines among individuals with LS. Additional efforts are required to increase clinic attendance or otherwise improve adherence among patients with LS.