Endometrial cancer and implementing MMR testing in West Yorkshire

 

Objective: The long-term NHS plan states that 75% of all cancers should be diagnosed at an early stage by 2028. Lynch syndrome increases the risk of developing endometrial cancer and affects approximately 1 in 280 people in the UK and its thought around only 5% of people with Lynch Syndrome have been diagnosed. National guidance recommends that all endometrial cancers are tested for Lynch Syndrome, and we wished to ensure this guidance was implemented in the West Yorkshire and Harrogate Cancer Alliance group.  

Design: We conducted a retrospective audit of all endometrial cancers across all members of the West Yorkshire and Harrogate Cancer alliance. This consisted of 7 trusts including both tertiary oncology units and district general hospitals. We audited all endometrial cancers in 2021 from all these trusts.

Method: We conducted a retrospective audit of each trust for all endometrial cancers that were diagnosed in 2021. We used electronic patient records to review the histology reports for each case as well as all patient documentation. We also reviewed the gynae-oncology MDT outcome forms and MMR testing reports.

Results: There were 384 endometrial cancers diagnosed in 2021 within the alliance. 84% of cancers were endometroid type. The percentage of patients that had MMR testing varied between trusts from 81% to 38%. 3.3% of patients who had MMR testing and needed referral to genetics did not have this done. We therefore developed an information leaflet for the alliance to share between all healthcare professionals and patients. This provided information about Lynch Syndrome and described the importance of the testing. We also shared our findings with the trusts.

Conclusions: Testing for Lynch Syndrome is an important element of care when looking after women with endometrial cancer. We hope to improve awareness of this across the alliance through educating patients and healthcare professionals