In conclusion, we found that the male carriers have a higher cumulative risk of CRC than the female carriers and carriers of mutations in MSH2 have a higher cumulative risk of CRC than carriers of mutations in MLH1. Since the cumulative risk of CRC in the patients with Lynch syndrome is much higher than that in the general population, the patients with Lynch syndrome should continue to undergo intensive cancer screening surveillance by using less invasive and less expensive screening tools. This evidence concerns the gene MLH1 and cancer.