Risk of cancer Lifetime risk and mean age at diagnosis for Lynch syndrome associated cancers Type of cancer Lifetime risk (%) Mean age at diagnosis (years)<unk>  52-58 44-61 Endometrial 25-60 48-62 Gastric 6-13 56 Ovarian 4-12 42.5 In addition to the types of cancer found in the chart above, it is understood that Lynch syndrome also contributes to an increased risk of small bowel cancer, pancreatic cancer, ureter/renal pelvis cancer, biliary tract cancer, brain cancer, and sebaceous neoplasms. Increased risk of prostate cancer and breast cancer has also been associated with Lynch syndrome, although this relationship is not entirely understood. Two-thirds of colon cancers occur in the proximal colon and common signs and symptoms include blood in the stool, diarrhea or constipation, and unintended weight loss. The mean age of<unk>  cancer diagnosis is 44 for members of families that meet the Amsterdam criteria. The average age of diagnosis of endometrial cancer is about 46 years. Among women with<unk>  who have both colon and endometrial cancer, about half present first with endometrial cancer, making endometrial cancer the most common sentinel cancer in Lynch syndrome. The most common symptom of endometrial cancer is abnormal vaginal bleeding. In<unk> , the mean age of diagnosis of gastric cancer is 56 years of age with intestinal-type adenocarcinoma being the most commonly reported pathology.<unk> -associated ovarian cancers have an average age of diagnosis of 42.5 years-old; approximately 30% are diagnosed before age 40. Significant variation in the rate of cancer has been found depending on the mutation involved. Up to the age of 75 years the risks of different cancers by the mutations are in the table below. Gene<unk>  cancer risk endometrial cancer risk ovarian cancer risk upper gastrointestinal (gastric, duodenal, bile duct or pancreatic) cancer risk urinary tract cancers risk prostate cancer risk brain tumor risk MLH1 46% 43% 10% 21% 8% 17% 1% MSH2 57% 17% 10% 25% 32% 5% n.a. MSH6 15% 46% 13% 7% 11% 18% 1% +Risk of gynecologic cancer in Lynch syndrome Gene Ovarian cancer risk Endometrial cancer risk MLH1 4-24% 25-60% MSH2/EPCAM 4-24% 25-60% MSH6 1-11% 16-26% PMS2 6% (combined risk) 15%
Hereditary nonpolyposis colorectal cancer
Familial adenomatous polyposis
MUTYH-associated polyposis
Serrated polyposis syndrome
Hereditary diffuse gastric cancer
Juvenile polyposis syndrome
Attenuated familial adenomatous polyposis
Peutz–Jeghers syndrome