Knowing your risk of cancer means you can have regular tests (screening). Bowel cancers and womb cancers can be curable when they're found early.
If a person is found to have inherited the altered gene, they will usually be advised to have regular bowel screening from a young age – normally 25. Women in their 30s may also be referred to a gynaecologist to discuss how to manage their risk of womb cancer.
If the altered gene isn’t found in the person with LS-type cancer, it's still important for you to have screening, as you may still be at risk of cancer. This is also true if you decide not to have genetic testing or can’t have it because a family member with LS-type cancer doesn’t want a test.
A test called a colonoscopy is used to examine the bowel and diagnose any cancers early on when they're curable.
The test is usually done in the hospital outpatient department and takes about an hour. Your bowel has to be completely empty for the test. This means you'll have to follow a special diet for a few days beforehand. On the day before your colonoscopy, you'll be asked to take medicine (a laxative) to empty your bowel. Your hospital will give you instructions about preparing for a colonoscopy. Just before the test, you will be given a drug to make you feel more relaxed (a sedative). This may be given as an injection into a vein (intravenously).
Once you're lying comfortably on your side, the doctor or nurse will gently pass a flexible tube (a colonoscope) into your back passage (rectum). A colonoscope is a long, thin, flexible tube that has a tiny light and a camera on the end of it. It can easily pass around curves, so most of the large bowel can be examined. During the test, photographs and samples of tissue (biopsies) may be taken. Any polyps (small growths) can also be removed before they develop into a cancer.
After the test, you will need somebody to go home with you and stay with you for 24 hours until the effects of the sedative wear off. It is important not to drive during this time. Colonoscopies are usually repeated every 1–2 years. If you’ve had a polyp removed, you may be asked to have another colonoscopy the following year.
It has been suggested that a regular dose of aspirin may help prevent bowel cancer in people who have the LS gene alteration. However, we don’t yet know what the most helpful dose is, and aspirin can have harmful side effects. More research is needed into the possible benefits of aspirin for people with LS. If you have the altered gene and you want to know more about aspirin, your doctor can advise you.
We don't yet know whether womb screening in women with LS is helpful. Some women may be offered it, but it's not available everywhere.
The womb can be screened using a procedure called a hysteroscopy or by using a vaginal ultrasound. Your doctor or nurse will explain which test you will have.
During a hysteroscopy, a thin, flexible tube with a light at the end is used to look inside the womb.
A vaginal ultrasound scan involves putting a small device that makes soundwaves into the vagina. The sound waves are then converted into a picture by a computer.
If you have LS, your risk of developing ovarian cancer is much lower than your risk of developing bowel or womb cancer.
There is currently no standard screening test for ovarian cancer. Some women may be offered it, or they may have had it done as part of a research trial. More research is needed to see what screening may be useful for women at risk of familial ovarian cancer.
Ovarian screening can involve a blood test, a vaginal ultrasound, or both. The blood test checks the levels of a protein called CA125.