From diagnosis of colorectal cancer to diagnosis of Lynch syndrome: The RM Partners quality improvement project.

Aim: The UK National Institute for Health and Care Excellence guideline DG27 recommends universal testing for Lynch syndrome (LS) in all newly diagnosed colorectal cancer (CRC) patients. However, DG27 guideline implementation varies significantly by geography. This quality improvement project (QIP) was developed to measure variation and deliver an effective diagnostic pathway from diagnosis of CRC to diagnosis of LS within the RM Partners (RMP) West London cancer alliance.

Adenocarcinoma in an ano-vaginal fistula in Crohn's disease.

Introduction: Fistulas are a relatively common occurrence in Crohn's disease (CD), and often present early in the disease process. Additionally, patients suffering from either CD or ulcerative colitis are shown to have an increased risk of colorectal malignancies compared with the general population.

Presentation Of Case: We present a case of adenocarcinoma in an ano-vaginal fistula in a patient with longstanding CD.