Amsterdam Criteria - Criteria

Criteria

The initial Amsterdam criteria were a series of clinical criteria that were colloquially known as the ‘‘3-2-1’’ rule. They were formulated to serve as a common starting point for future research into the genetics underlying the disease. The criteria were as follows:

  1. At least 3 relatives with histologically confirmed colorectal cancer, 1 of whom is a first degree relative of the other 2; familial adenomatous polyposis should be excluded;
  2. At least 2 successive generations involved;
  3. At least 1 of the cancers diagnosed before age 50.

These criteria were found to be too strict and were expanded to include the associated non-colorectal cancers in 1998. These were called the Amsterdam II clinical criteria for families with Lynch syndrome.

Each of the following criteria must be fulfilled:

  • 3 or more relatives with an associated cancer (colorectal cancer, or cancer of the endometrium, small intestine, ureter or renal pelvis);
  • 2 or more successive generations affected;
  • 1 or more relatives diagnosed before the age of 50 years;
  • 1 should be a first-degree relative of the other two;
  • Familial adenomatous polyposis (FAP) should be excluded in cases of colorectal carcinoma;
  • Tumors should be verified by pathologic examination.

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