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Int J Gynaecol Obstet ; 131(2): 142-6, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26365573

RESUMO

OBJECTIVE: To assess the availability and capacity of US-based integrated centers for the management of Lynch syndrome. METHODS: A cross-sectional survey of practice patterns in the care of patients with Lynch syndrome was conducted at 33 National Cancer Institute-designated cancer centers in the USA from March 1 to June 1, 2013. Each cancer center was contacted by telephone and the caller used a uniform scripted greeting and survey format. RESULTS: All centers routinely recommended colonoscopy. Other recommended screening modalities were hysterectomy and bilateral salpingo-oophorectomy (29/33; 88%), endoscopy (27/33; 82%), urinalysis (23/33; 70%), endometrial sampling (21/33; 64%), dermatologic examination (19/32; 59%), pelvic ultrasonography (18/33; 55%), serum CA125 level (14/33; 42%), urine cytology (14/33; 42%), computed tomography (1/33; 3%), and magnetic resonance imaging (1/33; 3%). Each center had a multidisciplinary team but the composition varied. A designated team leader was present at 21 centers (64%). Having a team leader was associated with an increased likelihood of recommending endoscopy (P=0.04) and dermatologic surveillance (P=0.01). Only 23 centers (70%) had a system in place for communicating follow-up with patients. CONCLUSION: The lack of consensus in practice patterns recorded among participating centers probably reflected the limited existing evidence on the usefulness of most screening modalities.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Prestação Integrada de Cuidados de Saúde/estatística & dados numéricos , Detecção Precoce de Câncer/métodos , Vigilância da População/métodos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Estudos Transversais , Prestação Integrada de Cuidados de Saúde/normas , Detecção Precoce de Câncer/normas , Endoscopia Gastrointestinal , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Estados Unidos
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