No Difference in Colorectal Cancer Incidence or Stage at Detection by Colonoscopy Among 3 Countries With Different Lynch Syndrome Surveillance Policies
| Autor: | Engel, C., Vasen, H.F., Seppala, T., Aretz, S., Bigirwamungu-Bargeman, M., Boer, S.Y. de, Bucksch, K., Buttner, R., Holinski-Feder, E., Holzapfel, S., Huneburg, R., Jacobs, M.A.J.M., Jarvinen, H., Kloor, M., Doeberitz, M.V., Koornstra, J.J., Kouwen, M. van, Langers, A.M., Meeberg, P.C. van de, Morak, M., Moslein, G., Nagengast, F.M., Pylvanainen, K., Rahner, N., Renkonen-Sinisalo, L., Sanduleanu, S., Schackert, H.K., Schmiegel, W., Schulmann, K., Steinke-Lange, V., Strassburg, C.P., Vecht, J., Verhulst, M.L., Cappel, W.D.T.N., Zachariae, S., Mecklin, J.P., Loeffler, M., German HNPCC Consortium, Dutch Lynch Syndrome, Finnish Lynch Syndrome Registry |
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| Přispěvatelé: | Gastroenterology and hepatology, Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Colorectal cancer Colonoscopy FAMILIES 0302 clinical medicine Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14] Stage (cooking) Tumor medicine.diagnostic_test MISMATCH REPAIR DEFICIENCY Incidence Incidence (epidemiology) Gastroenterology Middle Aged Lynch syndrome 3. Good health PREVALENCE POLYPOSIS 030220 oncology & carcinogenesis CARCINOMAS Female 030211 gastroenterology & hepatology Hereditary Colon Cancer Colorectal Neoplasms Adult medicine.medical_specialty HNPCC Genetic Risk Factor suolistosyövät perinnöllinen alttius INTERVAL CANCERS 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center Internal medicine ADENOMAS medicine Humans Lynchin oireyhtymä neoplasms paksusuolisyöpä Neoplasm Staging Proportional Hazards Models seulontatutkimus Hepatology Proportional hazards model business.industry MUTATIONS MORTALITY Interval ta3122 medicine.disease Colorectal Neoplasms Hereditary Nonpolyposis Confidence interval digestive system diseases business Index Colonoscopy |
| Zdroj: | Gastroenterology, 155, 5, pp. 1400-1409.e2 Gastroenterology, 155(5), 1400-1409.e2. W.B. Saunders Ltd Gastroenterology, 155, 1400-1409.e2 German HNPCC Consortium, the Dutch Lynch Syndrome Collaborative Group, and the Finnish Lynch Syndrome Registry 2018, ' No Difference in Colorectal Cancer Incidence or Stage at Detection by Colonoscopy Among 3 Countries With Different Lynch Syndrome Surveillance Policies ', Gastroenterology, vol. 155, no. 5, pp. 1400-1409.e2 . https://doi.org/10.1053/j.gastro.2018.07.030 Gastroenterology, 155(5), 1400-+. W B SAUNDERS CO-ELSEVIER INC Gastroenterology, 155(5), 1400 |
| ISSN: | 0016-5085 |
| Popis: | BACKGROUND & AIMS: Patients with Lynch syndrome are at high risk for developing colorectal cancer (CRC). Regular colonoscopic surveillance is recommended, but there is no international consensus on the appropriate interval. We investigated whether shorter intervals are associated with lower CRC incidence and detection at earlier stages by comparing the surveillance policies in Germany, which evaluates patients by colonoscopy annually, in the Netherlands (patients evaluated at 1-2-year intervals), and Finland (patients evaluated at 2-3-year intervals). METHODS: We collected data from 16,327 colonoscopic examinations (conducted from 1984 through 2015) of 2747 patients with Lynch syndrome (pathogenic variants in the MLH1, MSH2, or MSH6 genes) from the German HNPCC Consortium, the Dutch Lynch Syndrome Registry, and the Finnish Lynch Syndrome Registry. Our analysis included 23,309 person-years of cumulative observation time. Time from the index colonoscopy to incident CRC or adenoma was analyzed using the Kaplan-Meier method; groups were compared using the log-rank test. We performed multivariable Cox regression analyses to identify factors associated with CRC risk (diagnosis of CRC before the index colonoscopy, sex, mutation, age, and presence of adenoma at the index colonoscopy). RESULTS: The 10-year cumulative CRC incidence ranged from 4.1% to 18.4% in patients with low-and high-risk profiles, respectively, and varied with age, sex, mutation, and prior detection of CRC or adenoma. Observed colonoscopy intervals were largely in accordance with the country-specific recommendations. We found no significant differences in cumulative CRC incidence or CRC stage at detection among countries. There was no significant association between CRC stage and[GRAPHICS]time since last colonoscopy. CONCLUSIONS: We did not find a significant reduction in CRC incidence or stage of detection in Germany (annual colonoscopic surveillance) than in countries with longer surveillance intervals (the Netherlands, with 1-2-year intervals, and Finland, with 2-3-year intervals). Overall, we did not find a significant association of the interval with CRC risk, although age, sex, mutation, and prior neoplasia were used to individually modify colonoscopy intervals. Studies are needed to develop and validate risk-adapted surveillance strategies and to identify patients who benefit from shorter surveillance intervals. |
| Databáze: | OpenAIRE |
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