Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative.

Publication ,  Journal Article
Spinosa, D; Acosta, T; Wong, J; Kurtovic, K; Mewshaw, J; Collins, S; Kauff, N; Havrilesky, LJ; Strickland, KC; Previs, RA
Published in: Gynecol Oncol
January 2021

OBJECTIVE: To determine the feasibility and effectiveness of a quality improvement initiative (QI) to adopt universal screening for Lynch syndrome in uterine cancer patients at an institution that previously employed age-based screening. METHODS: Prior to the initiative, tumors of patients with uterine cancer diagnosed at age ≤ 60 years were screened for mismatch repair deficiency (MMR) and microsatellite instability (MSI). The QI process change model adopted universal testing of all uterine cancer specimens and implemented provider training, standardized documentation, and enhanced use of the electronic medical record (EMR). We compared screening rates, results of screening, follow up of abnormal results, and final diagnoses from the pre- and post-implementation periods. RESULTS: Pre- and post-implementation screening rates for women age ≤ 60 years at the time of diagnosis were 45/78 (57.7%) and 64/68 (94.5%), respectively. The screening rate for all patients with uterine cancer increased from 73/190 (38.4%) to 172/182 (94.5%). The rate of abnormal screening results increased from 15/190 (7.9%) to 44/182 (24.0%) cases. Genetics referral rates among screen positives increased from 3/15 (20.0%) to 16/44 (36.4%). Germline diagnoses increased from 2/190 (1.1%) with two Lynch syndrome diagnoses to 4/182 (2.2%) including three Lynch syndrome diagnoses and one BRCA1 germline diagnosis. The number of patients errantly not screened decreased from at least 32 patients to 3 patients after the intervention. CONCLUSIONS: Adherence to screening guidelines significantly improved after interventions involving provider education, optimal use of the EMR, and simplification of screening indications. These interventions are feasible at other institutions and translatable to other screening indications.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

January 2021

Volume

160

Issue

1

Start / End Page

169 / 174

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Quality Control
  • Oncology & Carcinogenesis
  • Middle Aged
  • Microsatellite Instability
  • Immunohistochemistry
  • Hysterectomy
  • Humans
  • Female
  • Early Detection of Cancer
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Spinosa, D., Acosta, T., Wong, J., Kurtovic, K., Mewshaw, J., Collins, S., … Previs, R. A. (2021). Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative. Gynecol Oncol, 160(1), 169–174. https://doi.org/10.1016/j.ygyno.2020.10.016
Spinosa, Daniel, Tatiana Acosta, Janice Wong, Kelli Kurtovic, Jennifer Mewshaw, Sarah Collins, Noah Kauff, Laura J. Havrilesky, Kyle C. Strickland, and Rebecca A. Previs. “Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative.Gynecol Oncol 160, no. 1 (January 2021): 169–74. https://doi.org/10.1016/j.ygyno.2020.10.016.
Spinosa D, Acosta T, Wong J, Kurtovic K, Mewshaw J, Collins S, et al. Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative. Gynecol Oncol. 2021 Jan;160(1):169–74.
Spinosa, Daniel, et al. “Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative.Gynecol Oncol, vol. 160, no. 1, Jan. 2021, pp. 169–74. Pubmed, doi:10.1016/j.ygyno.2020.10.016.
Spinosa D, Acosta T, Wong J, Kurtovic K, Mewshaw J, Collins S, Kauff N, Havrilesky LJ, Strickland KC, Previs RA. Universal screening for Lynch syndrome in uterine cancer patients: A quality improvement initiative. Gynecol Oncol. 2021 Jan;160(1):169–174.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

January 2021

Volume

160

Issue

1

Start / End Page

169 / 174

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Quality Control
  • Oncology & Carcinogenesis
  • Middle Aged
  • Microsatellite Instability
  • Immunohistochemistry
  • Hysterectomy
  • Humans
  • Female
  • Early Detection of Cancer