Implementing recommendations for routine mismatch repair (MMR) immunohistochemistry (IHC) testing of endometrial cancer and subsequent patient management

Lynch syndrome is associated with an increased risk of cancer, including endometrial cancer. We audited the introduction of a nurse-led testing and management pathway for Lynch syndrome. All 191 patients diagnosed with endometrial cancer at Somerset NHS Foundation Trust between January 2022 and December 2023 were tested for mis-match repair (MMR) protein immunohistochemistry; germline testing was offered to all 13 who were eligible. Seven patients were diagnosed with Lynch syndrome; all were referred for bowel screening and Helicobacter pylori testing. Information about prophylactic aspirin recommendations was missing for 3/7 patients. We established an effective, nurse-led Lynch syndrome testing pathway, in line with national guidelines.