Recognition of Lynch Syndrome Amongst Newly Diagnosed Colorectal Cancers at St. Paul’s Hospital

Background. Lynch Syndrome (LS) is the most common cause of inherited colorectal cancer (CRC). In British Columbia, most centres still use clinical criteria (Amsterdam II, Revised Bethesda, or the BC Cancer Agency’s criteria) to determine who should undergo further first-line testing in the form of microsatellite instability or immunohistochemistry staining. Given the limitations with this strategy, LS is thought to be underrecognized. Objective. To investigate whether LS is truly underrecognized when compared to the reported prevalence. Methods. A retrospective chart review of all CRC cases diagnosed at St. Paul’s Hospital from 2010 to 2013 was conducted. Results. 246 patients met inclusion criteria. 76% (83/109) with a family history of malignancy were unable to recall the specific malignancy or age of diagnosis. 18% (43/235) were only asked about a history of gastrointestinal related malignancy and 26% (65/246) met at least one of the three criteria but only 21% (13/63) received further investigation. Only 1.6% (4/246) had LS compared to the reported prevalence of 2–5% of all CRC cases. Conclusion. This data supports our hypothesis that LS is underrecognized. Issues at the patient, physician, and systems level need to be evaluated to determine where the limitations preventing appropriate testing are occurring.

Vigs: Implikasies vir Suid-Afrikaanse verpleegkundiges — Deel 1

At present the number of AIDS victims in South Africa has been small with only 19 cases reported by 19 July 1985. Nurses in South Africa should however understand AIDS (Auto Immune Deficiency Syndrome) so that a possible sudden increase in the number of cases does not Find them unprepared. AIDS is a disease characterised by the development of an inexplicable immune deficiency. These patients develop fatal opportunistic infections and a specific malignancy — Kaposi Sarcoma. AIDS is believed to be caused by a retro-virus named HTLV-III. It seems to be spread through sexual contact, blood, blood products, syringes of drug-addicts and to a baby during the birth process. The diagnosis of AIDS is made on the basis of an opportunistic infection or the development of a malignancy. Four patterns have been identified including the pulmonary, central nervous system, gastro-intestinal and fever o f unknown origin patterns. (Next issue: Nursing patients with AIDS).