6533b85bfe1ef96bd12bacef
RESEARCH PRODUCT
The “unnatural” history of colorectal cancer in Lynch syndrome : lessons from colonoscopy surveillance
Michael HoffmeisterGabriel CapelláFinlay A. MacraeJohn BurnRodney J. ScottHendrik BläkerEngel ChristophGabriela MösleinRobert HüneburgHermann BrennerMaartje NielsenMagnus Von Knebel DoeberitzJacob NattermannSanne W. Ten BroekeVerena Steinke-langeLuigi LaghiToni T. SeppäläToni T. SeppäläToni T. SeppäläJukka-pekka MecklinRichard GallonJulian R. SampsonElke Holinski-federAysel AhadovaAysel AhadovaPål MøllerMatthias KloorMev Dominguez-valentinHans F. A. Vasensubject
Cancer ResearchColorectal cancermedicine.medical_treatmentColonoscopyDNA Mismatch RepairADENOMA DETECTION0302 clinical medicineRisk FactorsEpidemiologyMass ScreeningProspective cohort studyMUTATIONRISKmedicine.diagnostic_testincident cancer riskColonoscopyTUMORSLynch syndrome3. Good healthOncology030220 oncology & carcinogenesisPopulation SurveillancesyöpätauditColorectal Neoplasmskoloskopiamedicine.medical_specialtyLONG-TERM3122 Cancerscolorectal cancersuolistosyövätINTERVAL CANCERS03 medical and health sciencesINTESTINAL MICROBIOTACàncer colorectalCOLONmedicineMANAGEMENTHumansLynchin oireyhtymäIntensive care medicinepaksusuolisyöpäperinnölliset tauditseulontatutkimusbusiness.industrymismatch repair deficiencyMicrosatellite instabilityCancerColonoscòpiamedicine.diseaseColorectal Neoplasms Hereditary NonpolyposisPolypectomydigestive system diseasesDNA Repair EnzymesLynch syndromemicrosatellite instabilitybusinesscolonoscopy surveillancedescription
Individuals with Lynch syndrome (LS), one of the most common inherited cancer syndromes, are at increased risk of developing malignancies, in particular colorectal cancer (CRC). Regular colonoscopy with polypectomy is recommended to reduce CRC risk in LS individuals. However, recent independent studies demonstrated that a substantial proportion of LS individuals develop CRC despite regular colonoscopy. The reasons for this surprising observation confirmed by large prospective studies are a matter of debate. In this review, we collect existing evidence from clinical, epidemiological and molecular studies and interpret them with regard to the origins and progression of LS-associated CRC. Alongside with hypotheses addressing colonoscopy quality and pace of progression from adenoma to cancer, we discuss the role of alternative precursors and of immune system in LS-associated CRC. We also identify gaps in current knowledge and make suggestions for future studies aiming at improved CRC prevention for LS individuals. Peer reviewed
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-02-15 |