The only current published study of reflex testing for Lynch syndrome in women with endometrial cancer to include no testing as a comparator found that IHC and MLH1 methylation triage was cost-effective, but costed approximately £14,000 per QALY gained for a 60-year-old endometrial cancer patient, and was not cost-effective for patients aged 65 years and older [13]. This evidence concerns the gene MLH1 and endometrial cancer.