N02: Opportunities For Collaboration: Analysis Of Longitudinal Data In Lynch Syndrome Carriers To Inform Development And Calibration/Validation Of A New LS Screening Model – “Policy1-Lynch”

Y. J. Kang1, M. Caruana1, N. Taylor1, I. Frayling2, A. Boussioutas3, 5, 6, P. Møller4, 7, 8, G. Mitchell5, F. Macrae6, K. Canfell1

1 – Cancer Research Division, Cancer Council NSW, Sydney, New south Wales, Australia. 2 – Genetic Pathology, Cardiff, Wales, UK. 3 – The University of Melbourne. 4 -Department of Medical Genetics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. 5 – Peter MacCallum Cancer Centre. 6 – The Royal Melbourne Hospital. 7 – Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, Oslo University Hospital, Olso, Norway Center for Hereditary Tumors. 8 – HELIOS-Klinikum Wuppertal, University of Witten-Herdecke, Wuppertal, Germany.


Aim: POLICY1-Lynch” is a comprehensive health economic model platform to simulate pathways for testing, diagnosis, surveillance and prophylaxis for Lynch syndrome (LS). POLICY1-Lynch has several core components, including a model of cancer-specific natural history that needs to be calibrated/validated using good quality data with a large sample size. Therefore, we propose a collaborative study with members of the EuropeanHereditaryTumourGroup to: i) estimate the underlying natural history of colorectal cancer (CRC) and other LS-related cancers; and ii) use the information for calibration/validation of the detailed natural history model in LS carriers.

Method: Additional data, if available, from each  centre currently contributing to the ProspectiveLynchSyndromeDatabase will be collated to estimate the: i) prevalence of pre-invasive/invasive lesions by histopathology/size at baseline colonoscopy; ii) cumulative incidence of adenoma/CRC, taking into account the effect of colonoscopic surveillance and surveillance interval; and iii) cumulative incidence of  non-colonic LS-related cancers/pre-cancerous lesions in LS, accounting for participation in a surveillance program and prophylactic options. The outcome measured will be stratified by MMR gene, sex, age group and site(colon/rectum) wherever possible.

Results: N/A

Conclusion: Significance: The calibrated model will allow accurate estimates of the effectiveness and cost-effectiveness of optimal screening and management options for LS in Australia and other countries.