Quality of endoscopic surveillance of Lynch syndrome patients in a Swedish cohort

Sophie Walton Bernstedt ^1,2,3, Adrianna Haxhijaj ¹, Nigin Jamizadeh ⁴

⁰Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden.

Endoscopy International Open +

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July 5, 2024

View abstract on PubMed

Summary

In Lynch syndrome patients, bowel preparation quality did not impact adenoma detection. However, older age and obesity were linked to poorer bowel cleanliness, while older age and male sex predicted adenoma detection.

Area Of Science

Gastroenterology
Oncology
Genetics

Background

Lynch syndrome (LS) patients have increased risk factors for colorectal cancer (CRC), including age, sex, BMI, and smoking.
Adequate bowel preparation, assessed by the Boston Bowel Preparation Scale (BBPS), is crucial for effective colonoscopy surveillance.
Poor bowel cleanliness may lead to missed adenomas, potentially increasing CRC risk in LS patients.

Purpose Of The Study

To investigate the association between BBPS scores and adenoma detection in LS patients.
To examine the correlation between BBPS scores and CRC detection, considering known CRC risk factors.
To evaluate the relationship between surveillance interval length and CRC detection in LS patients.

Main Methods

Retrospective cohort study of 366 LS patients undergoing 1,887 colonoscopies in Stockholm, Sweden (1989-2021).
Analysis of Boston Bowel Preparation Scale (BBPS) scores, adenoma detection, and CRC detection.
Linear and logistic regression models were used to test associations.

Main Results

No significant association was found between BBPS scores and the number of adenomas detected.
Lower BBPS scores were associated with older age (P=0.007) and obesity (P=0.024).
Higher adenoma detection rates correlated with older age (P<0.001), male sex (P=0.033), and CRC presence (P=0.012). Surveillance interval was not significant for CRC detection.

Conclusions

Bowel cleanliness (BBPS score) was not linked to adenoma detection in LS patients.
Older age and higher BMI were associated with poorer bowel preparation.
Adenoma detection was higher in older patients and males, suggesting targeted surveillance strategies.

Keywords:

Colorectal cancer Endoscopy Lower GI Tract Polyps / adenomas / ... Quality and logistical aspects