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Cancer risk in young women at risk of hereditary nonpolyposis colorectal cancer: implications for gynecologic surveillance.
Gynecol Oncol. 2001 Mar; 80(3):346-9.GO

Abstract

OBJECTIVES

The lifetime risk of endometrial and ovarian cancers in hereditary nonpolyposis colorectal cancer (HNPCC) is up to 60 and 12%, respectively, in addition to the high risk of colorectal cancer. International guidelines recommend surveillance of those at risk with colonoscopy every 1--2 years from age 20--25 years and annual gynecologic surveillance from 25--35 years for women. We reviewed our own experience to see whether these recommendations were appropriate.

METHODS

Pedigrees of 120 HNPCC families registered with the Familial Bowel Cancer Service at The Royal Melbourne Hospital were reviewed. Ninety families met our criteria for HNPCC and were included in the study. Pedigrees were analyzed to identify early-age onset colorectal and gynecologic cancers and to calculate cumulative incidence of both cancer types for at-risk women (HNPCC-affected and first-degree female relatives of affected family members) for comparison with the general population.

RESULTS

Colorectal cancer occurred in 434 individuals, endometrial cancer in 43, and ovarian cancer in 24. Gynecologic and colorectal cancers were diagnosed at similar ages (mean 49.3 versus 51.8 years; P = 0.25), with 5 (7.1%) gynecologic cancers diagnosed by 35 years. Cumulative incidences of gynecologic and colorectal cancers to ages 25, 30, 35, and 40 years were substantially higher among at-risk women than in the general population.

CONCLUSIONS

Consideration should be given to offering gynecologic cancer surveillance from the age of 25 years, as for colorectal cancer. However, this approach should be individualized as it has yet to be demonstrated that surveillance reduces the mortality of gynecologic cancer in HNPCC.

Authors+Show Affiliations

Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11263929

Citation

Brown, G J., et al. "Cancer Risk in Young Women at Risk of Hereditary Nonpolyposis Colorectal Cancer: Implications for Gynecologic Surveillance." Gynecologic Oncology, vol. 80, no. 3, 2001, pp. 346-9.
Brown GJ, St John DJ, Macrae FA, et al. Cancer risk in young women at risk of hereditary nonpolyposis colorectal cancer: implications for gynecologic surveillance. Gynecol Oncol. 2001;80(3):346-9.
Brown, G. J., St John, D. J., Macrae, F. A., & Aittomäki, K. (2001). Cancer risk in young women at risk of hereditary nonpolyposis colorectal cancer: implications for gynecologic surveillance. Gynecologic Oncology, 80(3), 346-9.
Brown GJ, et al. Cancer Risk in Young Women at Risk of Hereditary Nonpolyposis Colorectal Cancer: Implications for Gynecologic Surveillance. Gynecol Oncol. 2001;80(3):346-9. PubMed PMID: 11263929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cancer risk in young women at risk of hereditary nonpolyposis colorectal cancer: implications for gynecologic surveillance. AU - Brown,G J, AU - St John,D J, AU - Macrae,F A, AU - Aittomäki,K, PY - 2001/3/27/pubmed PY - 2001/4/3/medline PY - 2001/3/27/entrez SP - 346 EP - 9 JF - Gynecologic oncology JO - Gynecol Oncol VL - 80 IS - 3 N2 - OBJECTIVES: The lifetime risk of endometrial and ovarian cancers in hereditary nonpolyposis colorectal cancer (HNPCC) is up to 60 and 12%, respectively, in addition to the high risk of colorectal cancer. International guidelines recommend surveillance of those at risk with colonoscopy every 1--2 years from age 20--25 years and annual gynecologic surveillance from 25--35 years for women. We reviewed our own experience to see whether these recommendations were appropriate. METHODS: Pedigrees of 120 HNPCC families registered with the Familial Bowel Cancer Service at The Royal Melbourne Hospital were reviewed. Ninety families met our criteria for HNPCC and were included in the study. Pedigrees were analyzed to identify early-age onset colorectal and gynecologic cancers and to calculate cumulative incidence of both cancer types for at-risk women (HNPCC-affected and first-degree female relatives of affected family members) for comparison with the general population. RESULTS: Colorectal cancer occurred in 434 individuals, endometrial cancer in 43, and ovarian cancer in 24. Gynecologic and colorectal cancers were diagnosed at similar ages (mean 49.3 versus 51.8 years; P = 0.25), with 5 (7.1%) gynecologic cancers diagnosed by 35 years. Cumulative incidences of gynecologic and colorectal cancers to ages 25, 30, 35, and 40 years were substantially higher among at-risk women than in the general population. CONCLUSIONS: Consideration should be given to offering gynecologic cancer surveillance from the age of 25 years, as for colorectal cancer. However, this approach should be individualized as it has yet to be demonstrated that surveillance reduces the mortality of gynecologic cancer in HNPCC. SN - 0090-8258 UR - https://www.unboundmedicine.com/medline/citation/11263929/Cancer_risk_in_young_women_at_risk_of_hereditary_nonpolyposis_colorectal_cancer:_implications_for_gynecologic_surveillance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090825800960657 DB - PRIME DP - Unbound Medicine ER -