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CAP–AMP MMR / MSI Testing Guideline

Testing tumours for mismatch-repair deficiency and microsatellite instability to inform immunotherapy and screening.

Standards for testing mismatch-repair (MMR) and microsatellite instability (MSI) status.

What it is

A guideline from the College of American Pathologists (CAP), developed with the Association for Molecular Pathology (AMP) and partners, on testing tumours for mismatch-repair (MMR) deficiency and microsatellite instability (MSI).

Why it matters

MMR / MSI status can indicate whether a tumour may respond to immune checkpoint inhibitor (immunotherapy) treatment, and can flag cases that warrant screening for Lynch syndrome. It is most established in colorectal and endometrial cancers but is relevant across tumour types.

Key points

  • Assesses mismatch-repair (MMR) proteins by IHC and/or MSI by molecular methods
  • Informs eligibility for immune checkpoint inhibitor (immunotherapy) treatment
  • Helps flag cases for Lynch syndrome screening
  • Most established in colorectal and endometrial cancers

How our reporting uses it

When MMR / MSI testing is requested, our reporting reflects these principles so results are clear for both treatment and screening decisions.

This page summarises a widely used external standard for general educational purposes. It is not a substitute for the full guideline, for the definitive criteria, please refer to the current published version. Our diagnostic reports reference these standards as part of a commitment to internationally consistent reporting.
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