AIM: Colonic surveillance reduces the lifetime risk of colorectal cancer in patients with Lynch syndrome (hereditary nonpolyposis colorectal cancer) from 60 to 80% to 10% and confers a 7-year survival advantage. The British Society of Gastroenterologists recommends colonoscopy at least every 2 years from the age of 25. Currently in the UK, genetic diagnosis is made by a regional genetics service, and screening recommendations are made to the referring clinician. The aim of this study was to investigate compliance with and the effectiveness of large bowel surveillance in Lynch syndrome. METHOD: A retrospective longitudinal study of Lynch syndrome mutation carriers on the Regional Familial Colorectal Cancer Registry under and not under screening was conducted. To investigate screening compliance, patients were included if they were alive at the start of the study. Data were gathered on timeliness, quality and outcome of screening. To examine the effectiveness of screening, the cumulative incidence of colorectal cancer was estimated using Kaplan-Meier curves and the screened population compared with patients not being screened. RESULTS: A total of 227 Lynch syndrome mutation carriers were under screening at 26 hospitals. We assessed 439 colonoscopies for timeliness, of which 68% were compliant (interval < 27 months). Compliance on the 1 November 2011 was 87%. The cumulative incidence of colorectal cancer to the age of 70 was 25% (95% CI 17-32%) in the surveillance population and 81% (95% CI 78-84%) in 689 mutation-positive patients not being screened (P < 0.0001). CONCLUSION: Overall, 68% of colonoscopies were on time. The incidence of colorectal cancer was greatly reduced by screening but remained significant. Patients with Lynch syndrome need proactive surveillance management. Colorectal Disease
AIM: Colonic surveillance reduces the lifetime risk of colorectal cancer in patients with Lynch syndrome (hereditary nonpolyposis colorectal cancer) from 60 to 80% to 10% and confers a 7-year survival advantage. The British Society of Gastroenterologists recommends colonoscopy at least every 2 years from the age of 25. Currently in the UK, genetic diagnosis is made by a regional genetics service, and screening recommendations are made to the referring clinician. The aim of this study was to investigate compliance with and the effectiveness of large bowel surveillance in Lynch syndrome. METHOD: A retrospective longitudinal study of Lynch syndrome mutation carriers on the Regional Familial Colorectal Cancer Registry under and not under screening was conducted. To investigate screening compliance, patients were included if they were alive at the start of the study. Data were gathered on timeliness, quality and outcome of screening. To examine the effectiveness of screening, the cumulative incidence of colorectal cancer was estimated using Kaplan-Meier curves and the screened population compared with patients not being screened. RESULTS: A total of 227 Lynch syndrome mutation carriers were under screening at 26 hospitals. We assessed 439 colonoscopies for timeliness, of which 68% were compliant (interval < 27 months). Compliance on the 1 November 2011 was 87%. The cumulative incidence of colorectal cancer to the age of 70 was 25% (95% CI 17-32%) in the surveillance population and 81% (95% CI 78-84%) in 689 mutation-positive patients not being screened (P < 0.0001). CONCLUSION: Overall, 68% of colonoscopies were on time. The incidence of colorectal cancer was greatly reduced by screening but remained significant. Patients with Lynch syndrome need proactive surveillance management. Colorectal Disease
Authors: Rita Vale Rodrigues; Isabel Claro; Pedro Lage; Isadora Rosa; Sara Ferreira; João Pereira da Silva; António Dias Pereira Journal: Int J Colorectal Dis Date: 2018-03-09 Impact factor: 2.571
Authors: Kathleen F Mittendorf; Sarah Knerr; Tia L Kauffman; Nangel M Lindberg; Katherine P Anderson; Heather Spencer Feigelson; Marian J Gilmore; Jessica Ezzell Hunter; Galen Joseph; Stephanie A Kraft; Jamilyn M Zepp; Sapna Syngal; Benjamin S Wilfond; Katrina A B Goddard Journal: JCO Precis Oncol Date: 2021-11-03
Authors: Elisabeth F P Peterse; Steffie K Naber; Corinne Daly; Aaron Pollett; Lawrence F Paszat; Manon C W Spaander; Melyssa Aronson; Robert Gryfe; Linda Rabeneck; Iris Lansdorp-Vogelaar; Nancy N Baxter Journal: Clin Gastroenterol Hepatol Date: 2019-10-17 Impact factor: 11.382
Authors: Kevin J Monahan; Nicola Bradshaw; Sunil Dolwani; Bianca Desouza; Malcolm G Dunlop; James E East; Mohammad Ilyas; Asha Kaur; Fiona Lalloo; Andrew Latchford; Matthew D Rutter; Ian Tomlinson; Huw J W Thomas; James Hill Journal: Gut Date: 2019-11-28 Impact factor: 23.059
Authors: Pål Møller; Toni Seppälä; Inge Bernstein; Elke Holinski-Feder; Paola Sala; D Gareth Evans; Annika Lindblom; Finlay Macrae; Ignacio Blanco; Rolf Sijmons; Jacqueline Jeffries; Hans Vasen; John Burn; Sigve Nakken; Eivind Hovig; Einar Andreas Rødland; Kukatharmini Tharmaratnam; Wouter H de Vos Tot Nederveen Cappel; James Hill; Juul Wijnen; Kate Green; Fiona Lalloo; Lone Sunde; Miriam Mints; Lucio Bertario; Marta Pineda; Matilde Navarro; Monika Morak; Laura Renkonen-Sinisalo; Ian M Frayling; John-Paul Plazzer; Kirsi Pylvanainen; Julian R Sampson; Gabriel Capella; Jukka-Pekka Mecklin; Gabriela Möslein Journal: Gut Date: 2015-12-09 Impact factor: 23.059