Lynch syndrome is an inherited condition. That means that it’s passed down to a person from their parents.
People who have Lynch syndrome are at an increased risk of several types of cancer compared with the general population. One of these cancers is ovarian cancer.
In this article, we discuss how Lynch syndrome increases the risk of ovarian cancer and other types of cancers and what you can do to lower your risk of developing ovarian cancer if you have Lynch syndrome.
Lynch syndrome is caused by a single mutation in one of several genes that are involved in DNA mismatch repair. The proteins encoded by these genes are a vital part of DNA replication, the process by which DNA is copied in cells.
DNA mismatch repair proteins work to fix situations in which the building blocks of DNA, called nucleotides, pair incorrectly during DNA replication. When these mismatches aren’t fixed, they can lead to DNA changes that can cause cancer.
Lynch syndrome increases the risk of many different types of cancer, including ovarian cancer. The exact level of risk depends on which gene contains the mutation.
Overall, ovarian cancer is rare. The
In contrast, people with Lynch syndrome have a
In addition to ovarian cancer, people with Lynch syndrome are also at risk of several other types of cancer. These cancers typically develop at a younger age than is typical.
The table below shows these cancer types and the risk of developing them by age 50, according to a
| Location of cancer | Female risk | Male risk |
|---|---|---|
| Any location | up to 41.5% | up to 39.2% |
| Colon/rectum | up to 20.8% | up to 36.6% |
| Endometrium | up to 17.5% | |
| Stomach, small bowel, bile duct, pancreas | up to 2.2% | up to 2.1% |
| Kidney and ureter | up to 2.2% | up to 2.4% |
| Bladder | up to 2.1% | up to 4.3% |
| Brain | up to 0.6% | up to 1.1% |
| Prostate | — | up to 4.6% |
| Female breast | up to 3.3% | — |
It’s important to remember that cancer risk can vary based on factors like age and mutation type. Generally speaking, risk increases with age. Additionally, some mutations carry a higher risk of certain cancers, but not others.
Because of this, it’s important to discuss your individual cancer risk with a doctor if you have Lynch syndrome. They can give you a better idea of what to expect for your specific situation.
Since Lynch syndrome increases the risk of both ovarian and endometrial cancer, you may be wondering if getting a hysterectomy that also removes the ovaries is a good cancer prevention tactic.
A hysterectomy is a surgery to remove the uterus. The procedure to remove both ovaries and fallopian tubes is called a bilateral salpingo-oophorectomy. These procedures are typically done at the same time.
An older 2006 study of people with Lynch syndrome found that those who had risk-reducing surgery didn’t develop ovarian or endometrial cancer. These cancers were diagnosed in 5% and 33% of those that didn’t receive surgery, respectively.
As such, risk-reducing surgery is
In the meantime, talk with a doctor about cancer screenings, including those for ovarian cancer, that are recommended for people with Lynch syndrome. Staying on top of screenings can help detect cancer early, when it’s easier to treat.
Symptoms of ovarian cancer
Ovarian cancer can cause various symptoms. However, many of these don’t begin until the cancer is more advanced. Some to look out for include:
- pain in your abdomen or pelvis
- abdominal bloating
- feeling full shortly after eating
- increased urinary urgency or frequency
- fatigue
- constipation
- pain during sex
- periods that are heavier or more irregular than is typical for you
Many of these symptoms are caused by other more common conditions. However, being symptom aware is still important. See a doctor for any symptoms that happen more frequently or are more severe than usual.
If a close relative has Lynch syndrome or you have a strong family history of cancers associated with Lynch syndrome, it’s important to talk with a doctor. They may recommend that you receive genetic testing.
Eligibility for genetic testing for Lynch syndrome often follows a set of criteria called the
- have at least three relatives that have a cancer associated with Lynch syndrome and:
- one of these relatives is a close family member, such as a parent, sibling, or child, of the other two relatives
- at least two consecutive generations have been affected by cancers associated with Lynch syndrome
- at least one of the relatives received their cancer diagnosis at an age younger than 50
Genetic testing can help to determine if you have Lynch syndrome. If so, you’ll be referred to a genetic counselor who can help you understand your level of cancer risk and what preventive steps you can take.
If you’ve received a cancer diagnosis
If you’ve already received a diagnosis of a cancer that’s associated with Lynch syndrome, your cancer may be tested for markers associated with Lynch syndrome.
Guidelines called the revised
- are younger than age 50 at the time of your diagnosis
- have or had another cancer associated with Lynch syndrome
- are younger than age 60 and the cancer has specific characteristics associated with Lynch syndrome when a doctor looks at it under a microscope
- have a close relative, such as a parent, sibling, or child, who had cancer associated with Lynch syndrome diagnosed at an age younger than 50
- have two or more close or more distant relatives, such as grandparents, aunts, or uncles, that had a cancer associated with Lynch syndrome at any age
Only one of the criteria above must be met for testing to be recommended.
Techniques used to test for Lynch syndrome
Two techniques can be used to test your cancer for Lynch syndrome:
- Immunohistochemical staining:
Immunohistochemical staining is used to look for DNA mismatch repair proteins in a tissue sample. Missing one or more of these proteins suggests Lynch syndrome. - Microsatellite instability: Microsatellite instability testing is used to look at specific DNA sequences to see if they’ve changed in length due to DNA mismatch repair not functioning as it should. When these sequences are longer or shorter than expected, it can suggest Lynch syndrome.
If either or both of these tests suggest that you may have Lynch syndrome, genetic testing and genetic counseling will be recommended.
While people with Lynch syndrome have a higher risk of cancer, the outlook for people with these cancers is often positive. This is likely due to increased screening and prevention measures for people with Lynch syndrome.
A
Further, a 2016 review of 747 ovarian cancers in people with Lynch syndrome found that 65% were diagnosed at stage 1 or 2 and that those with a cancer diagnosis had good overall survival.
People with Lynch syndrome are also at risk of developing a second cancer. A
How common is Lynch syndrome?
Lynch syndrome affects an estimated
How is Lynch syndrome inherited?
Lynch syndrome is inherited in an autosomal dominant manner. That means that only one copy of a mutated gene needs to be present for a person to have Lynch syndrome.
We inherit a copy of each gene from each of our parents. So, if one parent has Lynch syndrome, you have a
Does everyone with Lynch syndrome get cancer?
No. Having Lynch syndrome means that you’re at an increased risk of developing cancer compared with the general population. However, it doesn’t mean that you’ll absolutely get cancer during your lifetime.
What is the typical age when people with Lynch syndrome get cancer?
According to the
The 2016 review discussed above found that the average age at diagnosis of ovarian cancer in people with Lynch syndrome was 45.3.
Lynch syndrome is an inherited condition that increases your risk of several different cancer types. One of these is ovarian cancer.
People with Lynch syndrome can benefit from regular screenings for ovarian cancer. Additionally, a risk-reducing hysterectomy with a bilateral salpingo-oophorectomy may be recommended after childbearing is complete.
The outlook for people with Lynch syndrome who have any of many types of cancer, including ovarian cancer, is generally positive. This is because many cancers are detected when they’re still in an earlier stage.
If you have a relative with Lynch syndrome or a strong family history of cancers associated with Lynch syndrome, talk with a doctor. They may recommend genetic testing to determine if you have Lynch syndrome.