Colonoscopy findings in high-risk individuals compared to an average-risk control population

Forsberg, Anna; Kjellström, Lars; Andréasson, Anna; Jaramillo, Edgar; Rubio, Carlos A.; Björck, Erik; Agréus, Lars; Talley, Nicholas J.; Lindblom, Annika

doi:10.3109/00365521.2014.966317

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…and additional details Interval From-to Interval From-to Modalities in addition to clinical examination Finland 2014 3 years 1985–2014 1 year 1995-2014 EB, ultrasound, CA12-5 [ 3 , 4 , 8 ] Denmark 2014 2 years 1991–2014 2 years 1991-2014 US [ 9 ] Germany 2014 1 year 1995–2014 1 year 1995-2014 US [ 10 , 17 ] Italy 2013 1-2 years (1 year when age > 40 years; adenoma) 1990–2013 2 years (1 years when age > 35 yrs.) 1990-2013 US, Pap smear [ 11 ] UK (Manchester) 2014 2 years 1994–2014 1 year 1990-2014 Hysteroscopy, US, CA12-5 [ 6 ] Sweden 2014 2 years 1990–2000 1 year 1992-2014 US, CA 12-5.Some patients: EB [ 25 , 26 ] 18 months 2000–2014 Australia 2014 1 year 1990–2014 1 year 1990-2005 US, EB, CA12-5 https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp106_0.pdf https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp106_0.pdf …”

Section: Introductionmentioning

confidence: 99%

Colorectal cancer incidence in path_MLH1 carriers subjected to different follow-up protocols: a Prospective Lynch Syndrome Database report

Seppälä

Pylvänäinen

Evans

et al. 2017

Hered Cancer Clin Pract

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BackgroundWe have previously reported a high incidence of colorectal cancer (CRC) in carriers of pathogenic MLH1 variants (path_MLH1) despite follow-up with colonoscopy including polypectomy.MethodsThe cohort included Finnish carriers enrolled in 3-yearly colonoscopy (n = 505; 4625 observation years) and carriers from other countries enrolled in colonoscopy 2-yearly or more frequently (n = 439; 3299 observation years). We examined whether the longer interval between colonoscopies in Finland could explain the high incidence of CRC and whether disease expression correlated with differences in population CRC incidence.ResultsCumulative CRC incidences in carriers of path_MLH1 at 70-years of age were 41% for males and 36% for females in the Finnish series and 58% and 55% in the non-Finnish series, respectively (p > 0.05). Mean time from last colonoscopy to CRC was 32.7 months in the Finnish compared to 31.0 months in the non-Finnish (p > 0.05) and was therefore unaffected by the recommended colonoscopy interval. Differences in population incidence of CRC could not explain the lower point estimates for CRC in the Finnish series. Ten-year overall survival after CRC was similar for the Finnish and non-Finnish series (88% and 91%, respectively; p > 0.05).ConclusionsThe hypothesis that the high incidence of CRC in path_MLH1 carriers was caused by a higher incidence in the Finnish series was not valid. We discuss whether the results were influenced by methodological shortcomings in our study or whether the assumption that a shorter interval between colonoscopies leads to a lower CRC incidence may be wrong. This second possibility is intriguing, because it suggests the dogma that CRC in path_MLH1 carriers develops from polyps that can be detected at colonoscopy and removed to prevent CRC may be erroneous. In view of the excellent 10-year overall survival in the Finnish and non-Finnish series we remain strong advocates of current surveillance practices for those with LS pending studies that will inform new recommendations on the best surveillance interval.Electronic supplementary materialThe online version of this article (10.1186/s13053-017-0078-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Colorectal cancer incidence in path_MLH1 carriers subjected to different follow-up protocols: a Prospective Lynch Syndrome Database report

Seppälä

Pylvänäinen

Evans

et al. 2017

Hered Cancer Clin Pract

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“…It is generally accepted that the vast majority of colonic carcinomas evolved from sporadic conventional (tubular or villous) adenomas (CoA) via the adenoma-carcinoma pathway [1][2][3][4]. In a survey of all colorectal adenomas registered at this hospital between 1993 and 2000, we found that, out of 3135 colorectal adenomas, 93% were sporadic CoAs and the remaining 7% traditional serrated adenomas (serrated and microtubular) [5].…”

Section: Introductionmentioning

confidence: 89%

“…The aim of this study was to assess the distribution of PCs and to explore possible p53 upregulation in NECS from a cohort of CoAs, the most frequent sporadic adenoma phenotype in the human colon .…”

Section: Introductionmentioning

confidence: 99%

Disparate cell proliferation and p53 overexpression in colonic crypts with normal epithelial lining found below the neoplastic canopy of conventional adenomas

Rubio

Schmidt

2019

The Journal of Pathology CR

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We previously found colonic crypts with normal epithelial lining but with corrupted shapes (NECS) beneath the adenomatous tissue of conventional adenomas (CoAs). Here we assessed the distribution of proliferating cells (PCs) and explored the possible occurrence of p53‐upregulated cells in the NECS in a cohort of CoAs. Sections from 70 CoAs and from 12 normal colon segments were immunostained with the proliferation marker Ki67. In 60 of the 70 CoAs, additional sections were immunostained for the tumor suppressor p53 protein. NECS with asymmetric, haphazardly distributed single PC or PC clusters were recorded in 80% of the CoAs, with a continuous PC domain in one or both slopes of the crypts in 17%, and with haphazardly distributed single PCs in the remaining 3% of the CoAs. In the 12 normal segments (controls), the colon crypts demonstrated normal shapes with symmetric PC domains limited to the lower third portion of the crypts. In 30% of the 60 CoAs immunostained with p53 the NECS revealed haphazardly distributed p53‐upregulated cells, singly or in clusters. In sum, the apparently normal epithelium of the NECS beneath the adenomatous tissue of CoAs revealed an unprecedented relocation of the normal PC domains. This unexpected event and the occurrence of p53‐upregulated cells strongly suggest that the crypts beneath the neoplastic tissue of CoAs harbor somatic mutations. The accretion of putative mutated NECS beneath the neoplastic canopy of CoA emerges as a previously unaddressed major event, an event that might play an important role in the histogenesis of CoA in the human colon.

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Trend of the polyp and adenoma detection rate by sex and age in asymptomatic average-risk and high-risk individuals undergoing screening colonoscopy, 2012–2019

Valian,

Hassan Emami,

Heidari

et al. 2023

Preventive Medicine Reports

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Colonoscopy findings in high-risk individuals compared to an average-risk control population

Abstract: Individuals with a family history of CRC have a high prevalence and cumulative risk of adenomas and advanced adenomas, and screening is motivated also in this risk group.

Cited by 5 publications

References 38 publications

Colorectal cancer incidence in path_MLH1 carriers subjected to different follow-up protocols: a Prospective Lynch Syndrome Database report

Colorectal cancer incidence in path_MLH1 carriers subjected to different follow-up protocols: a Prospective Lynch Syndrome Database report

Disparate cell proliferation and p53 overexpression in colonic crypts with normal epithelial lining found below the neoplastic canopy of conventional adenomas

Trend of the polyp and adenoma detection rate by sex and age in asymptomatic average-risk and high-risk individuals undergoing screening colonoscopy, 2012–2019

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