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Immune response against frameshift-induced neopeptides in HNPCC patients and healthy HNPCC mutation carriers.

race, and lifestyle factors (such as smoking). Although we acknowledged differences in risk based on these factors, we also recognized that the guideline message was complicated. We concluded that, presently, there are no data to indicate that CRC incidence or mortality would be reduced by tailored screening recommendations; furthermore, tailoring could conceivably decrease screening for a subset of vulnerable individuals owing to limited access to some screening modalities. In addition, we note that screening rates among all groups is low under current guidelines, and that providing different screening options for specific groups has the potential for increasing confusion and complexity, and could create further barriers to screening. Further study is needed to determine whether specific subgroups among “average-risk” individuals would benefit from customized screening recommendations. Currently, the most important message we can provide to these “higher” risk individuals is to get screened, beginning at age 50 years.