DNA mismatch repair and microsatellite instability in colorectal tumors: An observational study in the Veterans Affairs Health Care System

Justin Waller, Lin Gu, Amanda M. De Hoedt, Stephen J. Freedland, Tongtong Wang, Mayur Amonkar, Deepti Aurora-Garg, Kai Li Liaw, Amy Wehn, Zachary Klaassen

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Challenges in identifying microsatellite instability (MSI)/mismatch repair (MMR)-tested colorectal carcinoma (CRC) patients in electronic health records have led to gaps in the understanding of MSI-high/deficient mismatch repair prevalence. Methods: An algorithm to identify MSI-/MMR-tested Veterans Affairs patients was developed and an observational study of adult CRC patients with MSI/MMR testing from 2010 to 2018 was undertaken. Results: An optimized model to identify MSI-/MMR-tested patients yielded high positive predictive value (89.0%) and specificity (97.8%). The authors observed MSI-high/deficient mismatch repair CRC in 54 of 291 patients (18.6%); highest frequencies were observed in stages II (25.9%) and III (22.6%) and lowest in stage IV (5.8%). Conclusions: In this real-world study, the authors proposed a novel method of identifying MSI-/MMR-tested patients. Further validation and refinement of this model, and study in a larger CRC cohort, is warranted.

Original languageEnglish (US)
Pages (from-to)649-660
Number of pages12
JournalFuture Oncology
Volume18
Issue number6
DOIs
StatePublished - Feb 2022

Keywords

  • Veterans Affairs
  • colorectal cancer
  • microsatellite instability
  • mismatch repair

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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