DNA Mismatch Repair Deficiency Tumour Testing for Patients With Colorectal Cancer: Ethical Issues [Internet]

This HTA pertains to universal testing for deficient mismatch repair (dMMR) in colorectal cancer (CRC) patients. Tumour dMMR testing can serve two purposes: optimizing chemotherapy treatment in CRC patients and diagnosing Lynch syndrome (LS), a hereditary disorder that increases the risk of certain types of cancers. Universal testing is being considered because it is hypothesized that providing this testing on a broad scale will result in better chemotherapy outcomes for CRC patients and identification of potentially high-risk family members, which will amount to an overall reduction of cancer-related morbidity and mortality in the population. The intent is to initiate a process that could ultimately lead to fewer cancer-related harms in relatives of CRC patients who have LS. This inquiry analyzes and summarizes the ethical issues involved in the implementation of universal dMMR testing in CRC patients.