Barriers and facilitators of adherence to cancer prevention in Lynch Syndrome: an integrative review

BACKGROUND: Lynch Syndrome, the most common hereditary cancer syndrome affecting 1 in 279 Americans, relies on primary care providers to identify at-risk individuals and promote adherence to prevention strategies. However, adherence remains suboptimal. This review examines barriers and facilitators impacting adherence for individuals with Lynch Syndrome and their primary care providers. METHODS: A systematic search of six electronic databases (Embase, PubMed, MEDLINE, Google Scholar, CINAHL, and Web of Science) was conducted for studies published between 2011 and 2024. Studies examining barriers or facilitators to cancer prevention among individuals with Lynch Syndrome or primary care providers were included. Methodological quality was assessed using the Joanna Briggs Institute criteria for qualitative studies. RESULTS: Four studies met the inclusion criteria (sample sizes 13-60). Key barriers included limited provider and patient knowledge of Lynch Syndrome, psychological distress related to cancer risk, uncertainty surrounding follow-up protocols, and competing lifestyle priorities. Facilitators included strong wellness motivation, family support, and coordinated care pathways that support surveillance and preventive care. CONCLUSIONS: Adherence to cancer prevention in Lynch Syndrome is influenced by psychosocial factors and provider knowledge gaps. Addressing these barriers through targeted education and coordinated care models may improve adherence to prevention in this high-risk population.