Clinical diagnosis – Amsterdam criteria,Besthesda guideline
Clinical Diagnostic Criteria for Hereditary Nonpolyposis Colon Cancer
| Amsterdam Criteria (1991) |
| 1. Three of more relatives, of whom two are first-degree relative of the third, with documented colorectal cancer |
| 2. Cancer occurring across two or more generations |
| 3. One or more cancers diagnosed before age 50 |
| 4. Familial adenomatous polyposis excluded |
| Bethesda Guidelines (1997) |
| 1. Individuals who meet the Amsterdam criteria |
| 2. Individual with two HNPCC-related cancers (synchronous/metachronous colorectal cancers or extracolonic cancers) |
| 3. Individuals with colorectal cancer and a first-degree relative with |
| a. Colorectal cancer diagnosed before age 45 or |
| b. HNPCC-related extracolonic cancer diagnosed before age 45 or |
| c. Colorectal adenoma diagnosed before age 40 |
| 4. Individuals with colorectal cancer or endometrial cancer diagnosed before age 45 or |
| 5. Individuals with proximal colon cancer of undifferentiated type or histopathology diagnosed before age 45 |
| 6. Individuals with signet ring cell colorectal cancer diagnosed before age 45 |
| 7. Individuals with colorectal adenomas diagnosed before age 40 |
| HNPCC = hereditary nonpolyposis colorectal cancer. |
From Rodriguez-Bigas, M.A., Boland, C.R., Hamilton, S.R., et al.: A National Cancer Institute Workshop on hereditary nonpolyposis colorectal cancer syndrome: Meeting highlights and Bethesda guidelines. J. Natl. Cancer. Inst., 89: 1758, 1997
