Table 2. The revised Bethesda Guidelines for testing colorectal tumours for MSI 
Tumours from individuals should be tested for MSI in the following situations:
1. Colorectal cancer diagnosed in a patient who is <50 years of age
2. Presence of synchronous, metachronous colorectal or other HNPCC-associated tumours, regardless of age
3. Colorectal cancer with the MSI-H histology diagnosed in a patient who is <60 years of age
4. Colorectal cancer diagnosed in one or more first-degree relatives with an HNPCC-related tumour, with one of the cancers being diagnosed under age of 50 years
5. Colorectal cancer diagnosed in two or more first- or second-degree relatives with HNPCC-related tumours, regardless of age
Reference:  Umar A, Boland R, Terdiman JP et al. Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 2004; 96: 261–268.
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