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MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

CPT4 code

Name of the Procedure:

MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) Gene Analysis; Full Sequence Analysis

Summary

The full sequence analysis of the MLH1 gene is a genetic test used to identify mutations. These mutations can increase the risk of developing Lynch syndrome, also known as hereditary non-polyposis colorectal cancer (HNPCC), a condition that heightens the risk of certain types of cancer, particularly colorectal cancer.

Purpose

This procedure aims to identify genetic mutations in the MLH1 gene responsible for Lynch syndrome. Goal: To determine if a patient has a higher genetic risk for colorectal and other cancers, enabling personalized cancer prevention and management strategies.

Indications

  • A family history of Lynch syndrome or colorectal cancer.
  • Early onset of colorectal cancer (before age 50).
  • Multiple types of cancer within the same family or individual.
  • Known family history of MLH1 mutations.

Preparation

  • No specific fasting or medication adjustments required.
  • A detailed family medical history and previous genetic test results should be provided.
  • Pre-test genetic counseling is often recommended.

Procedure Description

  1. A blood or saliva sample is collected from the patient.
  2. DNA is extracted from the sample.
  3. The full sequence of the MLH1 gene is analyzed using advanced genetic sequencing technology.
  4. The sequence data is reviewed to identify any mutations.

Typically, no anesthesia or sedation is required as the procedure is non-invasive, involving just a sample collection.

Duration

The actual sample collection takes about 10-15 minutes. Full genetic analysis may take several weeks to complete.

Setting

The sample collection can be done in a hospital, outpatient clinic, or specialized genetic testing center. The analysis is performed in a specialized laboratory.

Personnel

  • Phlebotomist or healthcare provider for sample collection.
  • Geneticist or molecular biologist for gene analysis.
  • Genetic counselor for result interpretation.

Risks and Complications

  • Minor discomfort or bruising from blood draw.
  • Emotional impact of genetic test results (counseling is recommended).

Benefits

  • Identifies genetic risk factors, allowing for early cancer detection and prevention.
  • Informs personalized treatment and surveillance strategies for individuals and their families.
  • Results may be realized within several weeks, offering timely information for health management.

Recovery

  • No recovery time is necessary.
  • Patients may be advised to schedule follow-up appointments with a genetic counselor for result interpretation and next steps.

Alternatives

  • Other genetic tests for related genes (e.g., MSH2, MSH6).
  • Regular cancer screening without genetic testing.
  • Pros and cons: While alternative screenings can detect cancer early, genetic testing provides proactive risk management.

Patient Experience

  • The blood draw or saliva sample collection is quick and minimally invasive.
  • Anxiety while waiting for results is common; genetic counseling can assist with managing expectations and emotions.

Pain management is generally not necessary given the non-invasive nature of the sample collection. Comfort during the procedure includes standard measures like a comfortable environment and professional care.

Medical Policies and Guidelines for MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis

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