Prophylactic surgery in XXXX .

@entity1 @entity1204 @entity4309 @entity5 @entity74 @entity14
@entity4309 ( @entity4309 ) is caused by a germline mutations in DNA mismatch repair genes and is a @entity74 , responsible for 2-5% of all @entity14 ( @entity14 ) cases. Mutation carriers have a 60-85% risk of developing @entity14 . With the increasing use of genetic predisposition testing, @entity1 and health care providers must decide on @entity5 risk-reduction strategies. The @entity5 observed in families with @entity4309 are diagnosed at an unusually early age and may be multiple. The decision about which surgery is suitable should be made on the basis of @entity1 factors and preferences, with special emphasis on age, comorbidity, sphincteric function, and the ability of the @entity1 to cope with intensive surveillance. Colectomy decreases the risk of second @entity14 significantly. The estimated lifetime risk for @entity1204 is 40-60% in @entity1 with @entity4309 , and the mean age at diagnosis is around 50 years. This risk equals or exceeds the risk of @entity14 . The optimal management of the elevated risk for @entity5 in carriers of mutations for @entity14 is unclear. @entity1 who are gene mutation carriers should receive counseling about colectomy, and if @entity1 , prophylactic hysterectomy and bilateral oophorectomy.
