PURPOSE Lynch syndrome (LS) is the most common inherited cause of colorectal cancer. Although testing all colorectal tumors for LS is recommended, the uptake of reflex-testing programs within health systems has been limited. This multipronged study describes the design of a provincial program for reflex testing in Ontario, Canada. METHODS We recruited key stakeholders to participate in qualitative interviews to explore the barriers and facilitators to the implementation of a reflex-testing program. Data were analyzed in an iterative manner, key themes identified, and a framework for a proposed program developed. RESULTS Twenty-six key informants participated in our interviews, and several themes were identified. These included providing education for stakeholders (patients, primary care providers, surgeons); challenges with sustaining various resources (laboratory costs, increased workload for pathologists); ensuring consistency of reporting test results; and developing a plan to measure program success. Using these themes, a framework for the reflex-testing program was developed. At a subsequent stakeholder meeting, the framework was refined, and recommendations were identified. CONCLUSIONS This study identifies factors to ensure the effective implementation of a population-level program for reflex LS testing. The final product is a prototype that can be utilized in other jurisdictions, taking into account local environmental considerations.

中文翻译：

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为林奇综合征的反射测试计划建立能力的框架。

目的 Lynch 综合征 (LS) 是结直肠癌最常见的遗传原因。尽管建议对所有结直肠肿瘤进行 LS 检测，但卫生系统内反射检测项目的采用受到限制。这项多管齐下的研究描述了加拿大安大略省反射测试省级计划的设计。方法 我们招募了主要利益相关者参加定性访谈，以探索实施反射测试计划的障碍和促进因素。以迭代方式分析数据，确定关键主题，并为拟议计划制定框架。结果 26 名关键知情人参与了我们的采访，并确定了几个主题。其中包括为利益相关者（患者、初级保健提供者、外科医生）提供教育；维持各种资源的挑战（实验室成本、病理学家工作量增加）；确保报告测试结果的一致性；并制定衡量项目成功的计划。使用这些主题，开发了反射测试程序的框架。在随后的利益相关者会议上，对框架进行了改进，并确定了建议。结论 本研究确定了确保有效实施人口水平反射 LS 测试计划的因素。考虑到当地环境因素，最终产品是可在其他司法管辖区使用的原型。为反射测试方案制定了一个框架。在随后的利益相关者会议上，对框架进行了改进，并确定了建议。结论 本研究确定了确保有效实施人口水平反射 LS 测试计划的因素。考虑到当地环境因素，最终产品是可在其他司法管辖区使用的原型。为反射测试方案制定了一个框架。在随后的利益相关者会议上，对框架进行了改进，并确定了建议。结论 本研究确定了确保有效实施人口水平反射 LS 测试计划的因素。考虑到当地环境因素，最终产品是可在其他司法管辖区使用的原型。