Tags

Type your tag names separated by a space and hit enter

Development of colorectal tumors in colonoscopic surveillance in Lynch syndrome.

Abstract

BACKGROUND & AIMS

Mutation carriers in Lynch syndrome families have a high risk for developing colorectal cancer during their lifetime. This study was designed to assess the cumulative risk for the development of colorectal adenoma or carcinoma in prospective colonoscopic surveillance.

METHODS

Data from the Finnish Hereditary Colorectal Cancer Registry electronic database on 420 Lynch syndrome mutation carriers without previous colorectal tumors were reviewed. Between March 1982 and May 2005 the mutation carriers underwent a total of 1252 colonoscopies. The total follow-up time was 3150 years (mean, 6.7 y/patient).

RESULTS

The cumulative risk of adenoma by age 60 was estimated as 68% (95% confidence interval [CI], 50%-80%) in men and 48% (95% CI, 29%-62%) in women. The estimated cumulative risk up to age 60 years for the development of cancer found as a result of surveillance at an interval of 2-3 years was 35% (95% CI, 16%-49%) in men and 22% (95% CI, 7%-34%) in women. Half of the adenomas were located proximal to the splenic flexure. Extracolonic cancer was diagnosed in 73 patients (18%).

CONCLUSIONS

Adenoma would appear to be the most important lesion preceding cancer formation in Lynch syndrome and removal of adenomas decreases the risk for colorectal cancer (CRC). The Finnish surveillance protocol of colonoscopies at 2- to 3-year intervals facilitates patient adherence but includes an essential risk for CRC up to 60 years of age, but without CRC-related mortality when the surveillance instructions are followed.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland. jukka-pekka.mecklin@ksshp.fi

    , , , , , ,

    Source

    Gastroenterology 133:4 2007 Oct pg 1093-8

    MeSH

    Adenoma
    Adult
    Age Factors
    Carcinoma
    Colonoscopy
    Colorectal Neoplasms, Hereditary Nonpolyposis
    Disease Progression
    Female
    Finland
    Follow-Up Studies
    Humans
    Incidence
    Kaplan-Meier Estimate
    Male
    Mass Screening
    Middle Aged
    Mutation
    Practice Guidelines as Topic
    Predictive Value of Tests
    Prospective Studies
    Registries
    Risk Assessment
    Risk Factors
    Time Factors

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    17919485

    Citation

    Mecklin, Jukka-Pekka, et al. "Development of Colorectal Tumors in Colonoscopic Surveillance in Lynch Syndrome." Gastroenterology, vol. 133, no. 4, 2007, pp. 1093-8.
    Mecklin JP, Aarnio M, Läärä E, et al. Development of colorectal tumors in colonoscopic surveillance in Lynch syndrome. Gastroenterology. 2007;133(4):1093-8.
    Mecklin, J. P., Aarnio, M., Läärä, E., Kairaluoma, M. V., Pylvänäinen, K., Peltomäki, P., ... Järvinen, H. J. (2007). Development of colorectal tumors in colonoscopic surveillance in Lynch syndrome. Gastroenterology, 133(4), pp. 1093-8.
    Mecklin JP, et al. Development of Colorectal Tumors in Colonoscopic Surveillance in Lynch Syndrome. Gastroenterology. 2007;133(4):1093-8. PubMed PMID: 17919485.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Development of colorectal tumors in colonoscopic surveillance in Lynch syndrome. AU - Mecklin,Jukka-Pekka, AU - Aarnio,Markku, AU - Läärä,Esa, AU - Kairaluoma,Matti V, AU - Pylvänäinen,Kirsi, AU - Peltomäki,Päivi, AU - Aaltonen,Lauri A, AU - Järvinen,Heikki J, Y1 - 2007/08/14/ PY - 2006/08/08/received PY - 2007/07/12/accepted PY - 2007/10/9/pubmed PY - 2007/10/27/medline PY - 2007/10/9/entrez SP - 1093 EP - 8 JF - Gastroenterology JO - Gastroenterology VL - 133 IS - 4 N2 - BACKGROUND & AIMS: Mutation carriers in Lynch syndrome families have a high risk for developing colorectal cancer during their lifetime. This study was designed to assess the cumulative risk for the development of colorectal adenoma or carcinoma in prospective colonoscopic surveillance. METHODS: Data from the Finnish Hereditary Colorectal Cancer Registry electronic database on 420 Lynch syndrome mutation carriers without previous colorectal tumors were reviewed. Between March 1982 and May 2005 the mutation carriers underwent a total of 1252 colonoscopies. The total follow-up time was 3150 years (mean, 6.7 y/patient). RESULTS: The cumulative risk of adenoma by age 60 was estimated as 68% (95% confidence interval [CI], 50%-80%) in men and 48% (95% CI, 29%-62%) in women. The estimated cumulative risk up to age 60 years for the development of cancer found as a result of surveillance at an interval of 2-3 years was 35% (95% CI, 16%-49%) in men and 22% (95% CI, 7%-34%) in women. Half of the adenomas were located proximal to the splenic flexure. Extracolonic cancer was diagnosed in 73 patients (18%). CONCLUSIONS: Adenoma would appear to be the most important lesion preceding cancer formation in Lynch syndrome and removal of adenomas decreases the risk for colorectal cancer (CRC). The Finnish surveillance protocol of colonoscopies at 2- to 3-year intervals facilitates patient adherence but includes an essential risk for CRC up to 60 years of age, but without CRC-related mortality when the surveillance instructions are followed. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/17919485/Development_of_colorectal_tumors_in_colonoscopic_surveillance_in_Lynch_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(07)01476-X DB - PRIME DP - Unbound Medicine ER -