Findings Linking Mismatch Repair Mutation With Age at Endometrial and Ovarian Cancer Onset in Lynch Syndrome

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.