To the Editor We read with interest the article by Ryan et al1 suggesting that patients with truncating MLH1 mutations develop endometrial cancer (EC) at a later age compared with those with nontruncating mutations and that surveillance guidelines should be adapted to accommodate these findings. This is a relevant observation because interfamilial variance of the Lynch phenotype is a well-known problem and a tailor-made surveillance program would benefit patients. However, we believe that it is too early to draw such rigorous conclusions.
Suerink M, ten Broeke SW, Nielsen M. Findings Linking Mismatch Repair Mutation With Age at Endometrial and Ovarian Cancer Onset in Lynch Syndrome. JAMA Oncol. 2018;4(6):889–890. doi:10.1001/jamaoncol.2018.0256
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