Abstract：
BACKGROUND & AIMS:Two percent to 4% of all cases of colorectal cancer (CRC) are associated with Lynch syndrome. Dominant clustering of CRC (non-Lynch syndrome) accounts for 1%-3% of the cases. Because carcinogenesis is accelerated in Lynch syndrome, an intensive colonoscopic surveillance program has been recommended since 1995. The aim of the study was to evaluate the effectiveness of this program. METHODS:The study included 205 Lynch syndrome families with identified mutations in one of the mismatch repair genes (745 mutation carriers). We also analyzed data from non-Lynch syndrome families (46 families, 344 relatives). Patients were observed from January 1, 1995, until January 1, 2009. End points of the study were CRC or date of the last colonoscopy. RESULTS:After a mean follow-up of 7.2 years, 33 patients developed CRC under surveillance. The cumulative risk of CRC was 6% after the 10-year follow-up period. The risk of CRC was higher in carriers older than 40 years and in carriers of MLH1 and MSH2 mutations. After a mean follow-up of 7.0 years, 6 cases of CRC were detected among non-Lynch syndrome families. The risk of CRC was significantly higher among families with Lynch syndrome, compared with those without. CONCLUSIONS:With surveillance intervals of 1-2 years, members of families with Lynch syndrome have a lower risk of developing CRC than with surveillance intervals of 2-3 years. Because of the low risk of CRC in non-Lynch syndrome families, a less intensive surveillance protocol can be recommended.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Vasen HF,Abdirahman M,Brohet R,Langers AM,Kleibeuker JH,van Kouwen M,Koornstra JJ,Boot H,Cats A,Dekker E,Sanduleanu S,Poley JW,Hardwick JC,de Vos Tot Nederveen Cappel WH,van der Meulen-de Jong AE,Tan TG,Jacobs MA,Mohamedoi
10.1053/j.gastro.2010.02.053subject
Has Abstractpub_date
2010-06-01 00:00:00pages
2300-6issue
7eissn
0016-5085issn
1528-0012pii
S0016-5085(10)00326-4journal_volume
138pub_type
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