Cancer screening in adults with down syndrome, a proposal

Area of Science:

• Oncology
• Genetics
• Public Health

Background:

• Cancer surveillance policies for the general population may not be suitable for individuals with Down syndrome (DS) due to unique cancer distribution.
• The specific tumor profile in DS necessitates a re-evaluation of existing cancer screening strategies.

Purpose of the Study:

• To review cancer screening opportunities for adults with Down syndrome.
• To consider the specific tumor profile within the DS population when evaluating screening protocols.

Main Methods:

• A comprehensive literature review was conducted.
• The review focused on cancer screening opportunities and the tumor profile in adults with DS.

Main Results:

• Solid tumors are less common in adults with DS compared to the general population or individuals with intellectual disabilities.
• Breast cancer is rare in women with DS; colorectal cancer frequency is poorly documented; cervical cancer is rarely reported but can be advanced.
• Young men with DS have an elevated risk of testicular cancer.

Conclusions:

• Adapted cancer screening programs are recommended for adults with DS, including colon cancer screening.
• Breast cancer screening is not advised for women with DS, but annual clinical monitoring with potential imaging is suggested.
• Cervical cancer screening may be offered to sexually active women with DS from age 25.
• Annual testicular cancer surveillance through palpation is recommended for men with DS aged 15-45.
• Genetic predisposition warrants surveillance similar to family members.