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CION Cancer Clinics
Tested positive for MSH6: your next steps | CION Cancer Clinics
A positive MSH6 result means you carry an inherited fault that raises your risk of certain cancers, mainly of the womb lining and the bowel. It does not mean you have cancer, and nothing has to happen today. This page walks through the results appointment, the referrals and checks that follow, how the steps differ if you already have cancer, and how to tell your family. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- I have tested positive for MSH6. What happens now?
- What a positive MSH6 result changes
- What the next steps usually look like
- Terms from your results appointment
- How the next steps differ if you already have cancer
- What this page cannot tell you
- Four things people think after a positive result
- Common questions after a positive MSH6 result
The short answer
I have tested positive for MSH6. What happens now?
Nothing has to happen today. Over the next few weeks you will have a results appointment with a genetic counsellor, referrals to a gastroenterologist and, for women, a gynaecologist, and a plan for regular checks. You will also be helped to tell close relatives, who can then choose whether to be tested.
If you are well
A positive result means you carry a fault that raises your risk of certain cancers, mainly of the womb lining and the bowel. It does not mean you have cancer. Your plan is about finding problems early, or before they start, through regular colonoscopy and attention to a few key symptoms.
If you already have cancer
The result can matter for your treatment as well as for the future. Your oncologist may use it when choosing between treatment options, and your surgeon may factor it into the operation. The screening plan for your other organs starts once treatment is complete.
Why MSH6 gives you time
MSH6 is one of the milder Lynch genes. Its cancers tend to appear later in life than with MLH1 or MSH2, and they usually grow from polyps that colonoscopy can remove. That means there is time to plan properly, talk it through with your family and choose the centre where you want your checks done.
The first days after a positive result are often the hardest. It is normal to feel shocked, guilty or angry.Four areas of life
What a positive MSH6 result changes
Most of the change happens slowly, through appointments you plan ahead. Very little is urgent.
Your screening
Regular colonoscopy becomes part of life, usually from the early to mid thirties. Women add a gynaecology plan. Most people are also tested for the stomach infection H. pylori. Keeping every appointment matters more than any single test, so choose a centre you can reach reliably.
Your treatment, if you have cancer
Tumours that have lost mismatch repair can respond to different drugs, including immunotherapy. That decision comes from testing the tumour, which your oncologist arranges. Your surgeon may also weigh the result when deciding how much of the bowel or womb to remove.
Your family
Parents, brothers, sisters and adult children each have a one in two chance of carrying the same fault. A simple test for your exact variant can give them an answer.
What helps
- A copy of your report
- A short family letter from the clinic
- Counselling in Telugu for relatives who want it
Your choices
You can discuss daily aspirin, surgery on the womb and ovaries once a family is complete, and habits that lower risk. None of these needs to be decided in the first appointment.
Not sure whether this applies to you?
Ask an oncologistThe first few months
What the next steps usually look like
Results appointment
A genetic counsellor explains the result, checks your family tree again and answers questions. Bring a family member if it helps, and write your questions down beforehand.
Referrals are made
You are referred to a gastroenterologist for colonoscopy and, for women, a gynaecologist. If you are already under an oncologist, they are told too.
First checks are booked
Your first colonoscopy is timed around your age and family history. An H. pylori test is usually done early, since treating it is simple.
Relatives are told
You decide who to tell and when. The clinic can give you a letter and help you plan the conversation, especially with older parents.
Words you will hear
Terms from your results appointment
- Carrier
- Someone who has inherited the MSH6 fault. A carrier without cancer is not a patient and needs no treatment, only checks.
- Lynch syndrome
- The name of the condition an MSH6 fault causes. You may see either term on letters and reports.
- Surveillance
- Regular planned checks to find cancer early or prevent it, such as colonoscopy.
- Risk-reducing surgery
- An operation to remove an organ before cancer develops in it. For MSH6, this usually means the womb and ovaries.
- Mismatch repair deficient (dMMR)
- A tumour that has lost its proofreading. This is found on the tumour itself and can shape treatment.
- Cascade testing
- Offering testing to relatives one step at a time, starting with the closest.
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Side by side
How the next steps differ if you already have cancer
You are a well carrier
You already have cancer
Screening plan starts at the right age
Treatment comes first, then screening of other organs
No change to any medicines
Tumour testing may open immunotherapy options
Surgery is a choice for later
The surgeon may plan the operation around the result
Relatives can be tested at their own pace
Relatives can be tested at their own pace
Being straight with you
What this page cannot tell you
It cannot interpret your report. The exact variant, how it was classified and your own family history all shape the advice. What your specific variant means is a question for the counsellor who ordered the test.
It cannot plan your treatment
If you have cancer, decisions about surgery, chemotherapy or immunotherapy depend on the tumour itself, its stage and your health. Tumour testing is a separate question, covered under targeted therapy. Your oncologist brings the inherited result and the tumour result together.
Who this does not apply to
This page is for people with a confirmed harmful MSH6 variant. If your report says variant of uncertain significance, that is not a positive result and should not change your care. If a relative tested positive but you have not been tested, your next step is counselling and a test, not this plan.
If the worry is affecting your sleep, work or relationships, tell your counsellor. Support is part of the service.Commonly believed
Four things people think after a positive result
"A positive result means I have cancer."
It means a raised risk, not a diagnosis. Many MSH6 carriers never develop cancer, and regular checks catch most problems early.
"I should have surgery straight away to be safe."
Surgery on the womb and ovaries is one option among several, usually considered once a family is complete. Rushing into it brings its own harms, including early menopause.
"It is my fault my children might have this."
Nobody chooses their genes. Knowing about the fault gives your children the chance of testing and early screening that you did not have.
"I will lose my health insurance."
India has no settled law on this, and the question is worth raising with your counsellor. Existing cover is not normally withdrawn because of a test result, but new policies are a separate question.
Questions we are asked
Common questions after a positive MSH6 result
How soon do I need my first colonoscopy?
It depends on your age and family history. If you are already past the usual starting age, it is booked in the coming months rather than the coming days. If you have symptoms such as bleeding, tell the team, because that changes the timing.
Should I take aspirin?
A large trial found daily aspirin lowered bowel cancer risk in Lynch carriers. It carries a risk of stomach bleeding, so it is not right for everyone. Discuss it with your gastroenterologist before starting it.
Can I still have children?
Yes. Each child has a one in two chance of inheriting the fault. Some couples discuss testing during pregnancy or embryo testing with IVF, and many choose neither. A counsellor can explain the options without steering you.
Does my diet need to change?
No special diet prevents Lynch cancers. General advice helps: plenty of fibre, vegetables and pulses, less processed meat, little alcohol and no tobacco. Staying active and keeping a healthy weight also lower bowel cancer risk.
Who should I tell first?
Usually your parents, brothers, sisters and adult children, because they are most likely to share the fault. You choose the order and timing. A clinic letter explaining the result can make these conversations easier.
What does a positive result cost me going forward?
The main ongoing costs are colonoscopies, gynaecology reviews and any stomach checks. Relatives' single-site tests cost less than your first test. Ask the hospital's insurance desk what your scheme or policy covers before each procedure.
Is there a support group for Lynch families in India?
Formal groups are few so far. Your counsellor may know of families willing to talk, and international Lynch syndrome charities publish helpful material. Talking to one other carrier often helps more than reading.
Will I need to repeat the genetic test?
No. Your inherited genes do not change, so one confirmed result is enough for life. Keep the report safe and share a copy with every doctor who treats you, so it is never lost.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
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Sources
- GeneReviews (NCBI) — Lynch Syndrome
- National Cancer Institute — Genetics of Colorectal Cancer (PDQ) – Health Professional Version
- MedlinePlus Genetics — Lynch syndrome
- NHS — Predictive genetic tests for cancer risk genes
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Surveillance for MSH6 carriersThe checks you will start, organ by organTesting the family for MSH6How to bring relatives in, one step at a timeMSH6 mutation: which cancers and what riskWhat the result means for each organAspirin for Lynch syndrome: what the evidence showsBefore you decide on daily aspirin
Talk to us
Just received a positive MSH6 result?
We can book a results appointment with a genetic counsellor and coordinate your first checks. There is no rush and no pressure to decide anything today. One helpline serves every CION centre.