Lynch Syndrome-Associated Gynecological Malignancies

Lynch syndrome-associated gynecological malignancies include endometrial and ovarian cancer. Endometrial cancer is particularly common following colorectal cancer and may be a sentinel cancer. The lifetime incidence of endometrial cancer in patients with Lynch syndrome is 25–60%. Various studies have examined the characteristics and prognosis of Lynch syndrome-associated gynecological malignancies, but there is no consensus. Endometrial cancer is diagnosed by endometrial biopsy, but there is no established surveillance system. Patient education on initial symptoms, routine endometrial biopsy, and transvaginal ultrasonography are performed in clinical practice, but evidence for the efficacy of these methods is limited. The lifetime incidence of ovarian cancer ranges from 4 to 12% and many patients develop epithelial ovarian cancer. Ovarian cancer is initially diagnosed by imaging, with surgery required for definite pathological diagnosis. There is no surveillance system, but patient education, transvaginal ultrasonography, and measurement of serum CA125 are currently used. Prophylactic hysterectomy and bilateral salpingo-oophorectomy are candidates of surgical procedures for preventing Lynch syndrome-associated gynecological malignancies.