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Surveillance in Lynch syndrome: how aggressive?
S J Lanspa1, J X Jenkins, R J Cavalieri
1Department of Internal Medicine, Creighton University, Omaha, Nebraska.
The American Journal of Gastroenterology
|November 1, 1994
Summary
In Lynch syndrome families, 10.2% of patients developed colorectal cancer within five years of colonoscopy or resection. This highlights potential differences in interval neoplasms and missed adenomas compared to the general population.
Area of Science:
- Gastroenterology
- Oncology
- Genetics
Background:
- Lynch syndrome significantly increases colorectal cancer risk.
- Effective surveillance strategies are crucial for early detection in high-risk individuals.
Purpose of the Study:
- To determine the incidence of colorectal cancers following colonoscopic screening in patients with Lynch syndrome.
- To assess the risk of interval colorectal cancers in this population.
Main Methods:
- Review of colorectal cancer cases within Lynch syndrome families at the Creighton University Hereditary Cancer Institute.
- Analysis of prior colonoscopy history for identified cancer patients.
Main Results:
- Six patients (2.7%) developed colorectal cancer within 4.5 years of colonoscopic surveillance.
- 17 patients (7.6%) had metachronous colorectal cancers within 5 years of their first cancer resection.
- Overall, 10.2% of patients experienced colorectal cancer within 5 years of colonoscopy or resection.
Conclusions:
- A notable percentage of Lynch syndrome patients develop colorectal cancer within five years of screening or resection.
- The behavior of interval neoplasms and the significance of missed diminutive adenomas may be distinct in Lynch syndrome compared to the general population.