Authors
Baoshuai Liu, Juan Li, Guorong Wang, Changhua Zhuo, Xiaohong Yang, Nanxin Zheng, Cheng Xin, Hongli Yan, Wei Zhang, Xian Hua Gao
Published in
Familial cancer. Volume 25. Issue 4. Sep 10, 2026. Epub Sep 10, 2026.
Abstract
Hereditary colorectal cancer (HCRC), including Lynch syndrome (LS) and familial adenomatous polyposis (FAP), accounts for 5-10% of colorectal cancers (CRC); however, little is known about physicians' awareness and management of these conditions in China. We conducted a nationwide cross-sectional survey of 81 physicians from 81 Chinese hospitals using a 74-item questionnaire assessing genetic testing, pedigree management, and LS/FAP protocols. The mean annual CRC caseload was 1093 per hospital, in stark contrast to only 32 HCRC cases. The LS diagnosis rate was alarmingly low (0.83% vs. expected 2-3%). Although 95.1% of hospitals offered dMMR immunohistochemistry, only 85.3% of CRC patients received it. Genetic testing completion rates were poor: 74.1% and 76.5% of hospitals reported 0-25% completion for suspected HCRC patients and first-degree relatives, respectively. Major barriers included high costs (93.8%), lack of insurance coverage (75.3%), and patient refusal (51.9%). Fewer than one-third of centers adhered to National Comprehensive Cancer Network (NCCN) guidelines. Only 8.6% incorporated risk-reducing hysterectomy and bilateral salpingo-oophorectomy into standard practice. Merely 13.6% maintained family management systems, 23.5% employed genetic counselors, and 46.9% had received HCRC training. HCRC diagnosis and management in China are inadequate, with substantial guideline-practice gaps. Urgent interventions are needed to improve physician education, reduce financial barriers, and implement standardized protocols.
PMID:
42720829
Bibliographic data and abstract were imported from PubMed on 11 Sep 2026.
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