Newsletter Fall 2021

Updates to NCCN Genetic/Familial High-Risk Assessment

Breast, Ovarian, and Pancreatic Guidelines V.1.2022: Released August 11th, 2021

  • The overall document was reorganized to help make it easier to find what you are looking for. Some highlights include:
    • ‘Principles of Cancer Risk Assessment and Counseling’ section was moved to the beginning (pages EVAL-A 1 to 7)
    • Testing criteria were substantially reorganized and put into a table format, divided into general criteria relevant to all cancers and cancer-specific criteria (starts on page Crit-1)
  • Testing based on PARP inhibitor eligibility for earlier stage/high-risk BRCA-associated breast cancers (based on OlympiA trial results) was incorporated (page Crit-2)
  • In recognition that many other NCCN guidelines include inherited cancer content, a list of guidelines was compiled that include a ‘Principles’ section, testing indications, and/or cancer risk management (bottom of page Crit-1)
  • Gene-A table was updated as follows:
    • The information and order were revised to include absolute risk, management, and strength of evidence
    • Where available, type of breast cancer (or over-representation of specific type) was included
    • CDH1 – added ‘discussion of option for risk-reducing mastectomy’
    • Lynch Syndrome genes – ovarian cancer risks updated by gene
    • STK11 – clarified that ovarian cancer risk is for non-epithelial (sex cord) tumors
  • Added Gene-B table to list information on autosomal recessive conditions related to the inherited cancer genes listed in Gene-A table

Colorectal Cancer Guidelines V.1.2021: Released May 11th, 2021

  • Lynch Syndrome: Extensive updates to cancer risks among individuals with Lynch Syndrome (specified by gene – MLH1, MSH2, MSH6, PMS2, EPCAM)
  • Familial Adenomatous Polyposis: extensive revisions to duodenal findings and management
  • Peutz-Jeghers Syndrome: section extensively revised
  • Juvenile Polyposis Syndrome: section extensively revised
  • Gene table (Table 3 – starting on page GENE-3) updated and revised

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