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Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)

PREMM1,2 Model: Prediction Model for MLH1 and MSH2 Gene Mutations

The PREMM1,2 model is a clinical prediction rule designed to be used by healthcare professionals to estimate the probability that an individual carries a mutation in MLH1 or MSH2. Mutations in these genes are found in most patients with the Lynch syndrome. Learn more

Proband Information

("Proband" refers to the individual being evaluated. Ideally, this individual should have a cancer or adenoma diagnosis.)

How many separate colorectal
cancers has the proband had?



Has the proband had colonic adenoma(s)?


Has the proband had endometrial cancer?


Has the proband had another
HNPCC-associated cancer?

(Other HNPCC-associated cancers include ovary, stomach, small intestine, urinary tract/kidney, bile ducts, glioblastoma multiforme, sebaceousgland tumors, and pancreas.)

Relatives Information - First Degree

(Only from affected side of family)

How many first-degree relatives
have had colorectal cancer?


How many first-degree relatives
have had endometrial cancer?


Have any first-degree relatives
had another HNPCC-associated cancer?
Relatives Information - Second Degree

(Only from affected side of family)

How many second-degree relatives
have had colorectal cancer?


How many second-degree relatives
have had endometrial cancer?


Have any second-degree relatives
had another HNPCC-associated cancer?

Predicted Probability of Mutation

If the Predicted Probability of Mutation is more than five percent, please consider a genetic evaluation for your patient. You may refer your patient to our Cancer Risk and Prevention Clinic, by calling (617) 632-2178 to schedule a clinic appointment. If you are not in the Boston area, please contact a cancer center nearest you, and they may be able to refer you to a genetics program in your area.

Additional Information

We developed the Prediction of MLH1 and MSH2 Mutations model (PREMM1,2) as a web-based tool for clinicians evaluating patients at risk for Lynch Syndrome. For those investigators who want to use the equation on which the model is presented, please consider the clarifications summarized in this table to ensure that the correct values are obtained, and/or check the results with those obtained with this excel spreadsheet.

For any further questions, please contact us at: ssyngal@partners.org or jbalmana@vhebron.net

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Related Information

This calculator was featured in The Journal of the American Medical Association.
learn more about the tool

To evaluate your risk for many different cancers, use the Harvard Center for Cancer Prevention tools.