How Should Colonoscopy Surveillance in Lynch Syndrome Be Performed?

Latchford, Andrew

doi:10.1053/j.gastro.2019.12.022

Cited by 10 publications

(12 citation statements)

References 18 publications

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“…Contrary to sporadic adenoma, there is no minimal adenoma detection rate requirement and its use as a KPI could be cautious as data are limited. 18,24 Of note, back-to-back studies reported high adenoma miss rates, ranging from 12% to 74%, [35][36][37][38] compared to 2% to 26% in the average-risk population. 39,40 Further studies are necessary to determine the minimal adenoma detection rates and assess whether it has an impact on post-colonoscopy CRC occurrence or not.…”

Section: Quality Standardsmentioning

confidence: 99%

“…When these quality criteria are not met, a new colonoscopy must be scheduled within the next 3 months. Contrary to sporadic adenoma, there is no minimal adenoma detection rate requirement and its use as a KPI could be cautious as data are limited 18,24 . Of note, back‐to‐back studies reported high adenoma miss rates, ranging from 12% to 74%, 35–38 compared to 2% to 26% in the average‐risk population 39,40 .…”

Section: Screening Colonoscopy Modalitiesmentioning

confidence: 99%

“…We believe that although ICC is time consuming, it can be a helpful aid especially for endoscopists with low adenoma detection rates. As stated by other experts, we consider that any adjunct that can be used to improve colonoscopy in LS should not be excluded 18 …”

Section: Screening Colonoscopy Modalitiesmentioning

confidence: 99%

“…17 The lack of specific quality metrics for screening colonoscopy, probably responsible for missed preneoplastic lesions, could also explain these numbers. 18 Therefore, an intensive surveillance strategy with early and regular colonoscopies is warranted to reduce the risk of post-colonoscopy CRC. In this review, we will focus on the modalities of CRC screening in LS patients.…”

Section: Introductionmentioning

confidence: 99%

“…Development of CRC from normal mucosa without a polyp precursor, probably arising from deficient MMR crypt foci could account for these findings 17 . The lack of specific quality metrics for screening colonoscopy, probably responsible for missed preneoplastic lesions, could also explain these numbers 18 . Therefore, an intensive surveillance strategy with early and regular colonoscopies is warranted to reduce the risk of post‐colonoscopy CRC.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Colorectal cancer screening in Lynch syndrome: Indication, techniques and future perspectives

Perrod

Rahmi

Cellier

2020

Digestive Endoscopy

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Lynch syndrome (LS) is an inherited predisposition to colorectal cancer (CRC), responsible for 3-5% of all CRC. This syndrome is characterized by the early occurrence of colorectal neoplastic lesions, with variable incidences depending on the type of pathogenic variants in MMR genes (MLH1, MSH2, MSH6, PMS2 and EPCAM) and demographics factors such as gender, body mass index, tobacco use and physical activity. Similar to sporadic cancers, colorectal screening by colonoscopy is efficient because it is associated with a reduction >50% of both CRC incidence and CRC related mortality. To that end, most guidelines recommend high definition screening colonoscopies in dedicated centers, starting at the age of 20-25 years old, with a surveillance interval of 1-2 years. In this review, we discuss the importance of high definition colonoscopies, including the compliance to specific key performance indicators, as well as the expected benefits of specific imaging modalities including virtual chromoendoscopy and dye-spray chromoendoscopy.

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Section: Quality Standardsmentioning

confidence: 99%

Section: Screening Colonoscopy Modalitiesmentioning

confidence: 99%

Section: Screening Colonoscopy Modalitiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Colorectal cancer screening in Lynch syndrome: Indication, techniques and future perspectives

Perrod

Rahmi

Cellier

2020

Digestive Endoscopy

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Prospective observational data informs understanding and future management of Lynch syndrome: insights from the Prospective Lynch Syndrome Database (PLSD)

et al. 2020

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The Prospective Lynch Syndrome Database (PLSD) has been developed as an international, multicentre, prospective, observational study that aims to provide age and organ-specific cancer risks according to gene and gender, estimates of survival after cancer and information on the effects of interventions. Recent reports from PLSD provided improved estimates of cancer risks and survival and showed that different time intervals between surveillance colonoscopies did not affect the incidence, stage or prognosis of colorectal cancer. The PLSD reports suggest that current management guidelines for Lynch syndrome should be revised in light of the different gene and gender-specific cancer risks and the good prognosis for the most commonly associated cancers. In this review, we describe the discrepancies between the current management guidelines for Lynch Syndrome and the most recent prospective observational studies, indicating the areas of further research.

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Progress Report: New insights into the prevention of CRC by colonoscopic surveillance in Lynch syndrome

Vasen

2021

Familial Cancer

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Lynch syndrome is the most frequent hereditary colorectal cancer (CRC) syndrome, affecting approximately 1 in 300 in the Western population. It is caused by pathogenic variants in the mismatch repair (MMR) genes including MLH1, MSH2 (EPCAM), MSH6 and PMS2, and is associated with high risks of CRC, endometrial cancer and other cancers. In view of these risks, carriers of such variants are encouraged to participate in colonoscopic surveillance programs that are known to substantially improve their prognosis. In the last decade several important studies have been published that provide detailed cancer risk estimates and prognoses based on large numbers of patients. These studies also provided new insights regarding the pathways of carcinogenesis in CRC, which appear to differ depending on the specific MMR gene defect. In this report, we will discuss the implications of these new findings for the development of new surveillance protocols.

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How Should Colonoscopy Surveillance in Lynch Syndrome Be Performed?

Abstract: See "White-light endoscopy is adequate for Lynch syndrome surveillance in a randomized and noninferiority study," by Rivero-Sánchez L, Arnau-Collell C, Herrero J, et al on page 895.

Cited by 10 publications

References 18 publications

Colorectal cancer screening in Lynch syndrome: Indication, techniques and future perspectives

Colorectal cancer screening in Lynch syndrome: Indication, techniques and future perspectives

Prospective observational data informs understanding and future management of Lynch syndrome: insights from the Prospective Lynch Syndrome Database (PLSD)

Progress Report: New insights into the prevention of CRC by colonoscopic surveillance in Lynch syndrome

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