During DNA replication or when there is a mistake in forming new DNA, there are certain genes which are responsible for correcting this mistake. However, this mechanism gets abnormal due to mutation in those genes in some patients. These patients are at higher risk for developing cancer and the condition is called as Lynch syndrome.
What Cancers Are Associated With Lynch Syndrome?
Following are the cancers which are generally associated with the Lynch Syndrome:
Colorectal Cancer: One of the primary risks of Lynch syndrome is the development of cancer. It is to be noted that males are slightly at higher risk as compared to females. The highest risk of this cancer is found in patients having mutation in MSH2 and MSH6.
Endometrial Cancer: Risk of endometrial cancer from Lynch disease is high and proper screening should be done in females having the family history of Lynch syndrome. Highest risk is in the mutation of MSH6.
Ovarian Cancer: Mutation of all the genes does not increases the risk of ovarian cancer, for e.g. mutation in MSH6 and PMS2 does not increases the risk as compared to general population.
Gastric Cancer: Gastric cancer risk is also associated with Lynch Syndrome. Prolonged indigestion, fatigue and dark stools are the symptoms of gastric cancer. Mutation in MSH6 does not cause increased risk while mutation in MLH1 and MSH2 significantly increases the risk.
Pancreatic Cancer: Lynch syndrome also increases the risk of occurrence pancreatic cancer. No increased risk found in patients with MSH6 mutation while increased risk in found in patients with MLH1 and MSH2 mutation.
Urinary Tract Cancer: Urinary tract includes all the system organs such as ureter, urinary bladder and kidney. Patients with mutation in MLH1 and MSH2 are at higher risk as compared to mutation in MSH6.
Small Bowel Cancer: Females are relatively at lower risk as compared to males in small bowel cancer risk due to Lynch syndrome. Patients with mutation in MLH1 and MSH2 are at higher risk as compared to mutation in MSH6.
Brain Cancer: Patients with Lynch syndrome are at higher risk of developing brain cancer as compared to people who have no abnormality in the DNA repairing mechanism.
Hepatic Cancer: Hepatic cancer risk involves cancer risk in liver and bile ducts. Mutation in MLH1 has higher risk as compared to mutation in MSH6.
Lynch Syndrome Causes
Lynch syndrome is caused due to the mutation in the DNA repairing genes thus increasing the risk of various cancers and the highest risk is of colorectal cancer. The ability of the cell to repair its DNA is severely hampered due to the mutation and the mistake in DNA, without any repair, increases the risk of cancer. However, it is yet remain unknown why the risk of certain types of cancer is more, for e.g. colorectal cancer, as compared to other cancers. The types of the gene involved in Lynch syndrome are MLH1, MSH2, MSH6 and PMS2. A rare gene is also involved known as EPCAM.
The risk of a particular type of cancer depends upon the type of gene involved in mutation. Thus, mutation of some genes increases colorectal cancer risk while other gene mutation may increase the risk of endometrial cancer. As there is a gene mutation in the cell and this is a dominant character, Lynch syndrome is inheritable. It is to be noted that the cancer is not inherited rather the risk of developing cancer is inherited. Thus, for the diagnosis of this syndrome, the family history plays a crucial role. Other factors that relates to the risk of developing cancer due to Lynch disease includes age, gender, family history of the disease and previous cancer diagnosis. Further research is currently being done to identify various other aspects of Lynch disease and other genes involved.
Various cancers are associated with Lynch syndrome such as colorectal, endometrial, ovarian, hepatic, gastric, urinary tract, pancreatic, small bowel and brain cancer. However, it remains unknown why the mutation in these genes have a greater risk of certain types of cancer as compared to other cancers.
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