Implementing universal Lynch syndrome screening (IMPULSS): protocol for a multi-site study to identify strategies to implement, adapt, and sustain genomic medicine programs in different organizational contexts

Table 1 Participating Healthcare Systems and Lynch Syndrome Screening by Clinical Site

		Lynch Syndrome Screening Program Type^a
			CRC Tumor Screening^b			EC Tumor Screening^c
Healthcare System	Clinical Site (State)	No Program	CRC age cutoff	BRAF Reflex	PHM Reflex	EC age cutoff	PHM Reflex
Geisinger	Geisinger (PA)		All ages	X	X	All ages	X
Kaiser Permanente (KP)	KP-Colorado (CO)	X
Kaiser Permanente (KP)	KP-Northwest (OR/WA)		All ages	X	X	All ages	X
Sutter Health (SH)	SH-Palo Alto Medical Foundation (CA)	X
Meyers Primary Care Institute (MCPI)	Reliant Medical Group (MA)		All ages
HealthPartners	HealthPartners (MN)		All ages	X	X	All ages	X
Harvard Pilgrim Healthcare	Harvard Pilgrim (MA)	X
Catholic Health Initiatives (CHI)	Franciscan (WA)		All ages	X	X	All ages	X
	Tri Health (OH)		All ages	X	X	All ages	X
	Mercy Des Moines (IA)		All ages	X	X	All ages
	Kentucky One (KY)		All ages
	Chattanooga (TN)		All ages	X	X	All ages	X
	Good Samaritan (NE)	X
	Lincoln (NE)		< 70 years	X
	St. Francis (NE)	X
	St. Joes Bryan (TX)	X
	St. Vincent (AR)	X
	Centura (CO)		< 70 years			< 60 years
	Alegent Creighton (OH)	X
	St. Alexius (ND)	X
	Mercy (ND)	X

^aRecommendation: screen all Colorectal cancer (CRC) and Endometrial Cancer (EC) tumors for mismatch repair deficiency
^bRecommendation: reflex test positive screens for BRAFV600E point mutation and MLH1 Promoter Hypermethylation (PHM) testing to rule out somatic loss of function (sporadic cancer)
^cRecommendation: reflex test positive screens for PHM to rule out somatic loss of function (sporadic cancer)

ISSN: 1472-6963