A new study co-authored by Dr. Felice Schnoll-Sussman, Director of the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian and Weill Cornell Medicine, shows promising results for combined colon and endometrial screening for patients with Lynch syndrome, a genetic condition in which individuals face up to a 60% lifetime risk of developing endometrial and gastrointestinal cancers.
This patient-centric program evolved from the desire to improve the quality of life and quality of care of these patients by not only improving the efficiency of their care but also decreasing their exposure to potentially painful procedures.
Established surveillance guidelines for females with Lynch syndrome require frequent, separate procedures: colonoscopies every 1-2 years starting at ages 20–25, and endometrial biopsies every year beginning at age 30–35.
The study’s first author, Dr. Christine Frissora, an associate attending physician at NewYork-Presbyterian and an associate professor of clinical medicine at Weill Cornell Medicine, stressed that an endometrial biopsy can be very painful and uncomfortable for patients, sometimes limiting the quality and number of the samples that can be collected. Recognizing these challenges, a multidisciplinary team of Weill Cornell Medicine specialists, including Drs. Schnoll-Sussman, Melissa Frey, and Steven Lipkin, developed an innovative approach: offer one-stop combined colon and endometrial screening—hence the name of the study “ONCE”.
Through highly coordinated interdisciplinary scheduling, a patient is offered an endometrial biopsy at the time of their surveillance gastrointestinal endoscopic procedures. This method allows for patients to be undergo both a colonoscopy and an endometrial biopsy during a single appointment under anesthesia, significantly improving patient comfort and reducing time and logistical burdens.
“The idea was simple. Get both doctors into the same room, at the same time, to make the life of their patient better,” said Dr. Schnoll-Sussman. “It may seem simple, but the choreography was quite complex. Merging busy clinical physician schedules, outfitting special equipment in the endoscopy unit, training personnel. It was a passion project but one that has paid off with big rewards.”
“This should be a standard of care for the patients,” said Dr. Frissora.
Between June 2021 and September 2023, the team enrolled patients in the ONCE study and assessed their outcomes through satisfaction surveys. The satisfaction scores were very high across the board. Patients not only appreciate that combining these visits is a true time-saver, but also that it helps them avoid the fear associated with a potentially painful procedure every year.
Dr. Frissora and Dr. Schnoll-Sussman hope the study will encourage other institutions to adopt the model.
The study marks a pivotal shift in how cancer prevention can be delivered to genetically at-risk populations and sets a new precedent for future screening protocols.