For Lynch syndrome screening universal screening testing is recommended for patients with colorectal cancer. Other Lynch spectrum tumours should also be tested if there is clinical suspicion of Lynch syndrome due to early age of onset (esp before 50 yo), family history of cancer, or presentation with multiple tumours. Tumour types include but are not limited to endometrial carcinoma, gastric carcinoma, small intestinal carcinoma, upper urothelial tract carcinoma and sebaceous neoplasms.
For immunotherapy we are testing all patients with stage 4 colorectal cancer or any other gastrointestinal tract tumour.