Higher surveillance in hereditary nonpolyposis colorectal cancer patients catches tumors early

-- Jeff Muise

Thursday, February 25, 2010 (Last Updated: 02/26/2010)

THURSDAY, Feb. 25 (HealthDay News) -- Annual colonoscopies can provide timely detection of early-stage colorectal cancer (CRC) in the high-risk group of people with the genetic condition known as hereditary nonpolyposis colorectal cancer (HNPCC), according to a study in the February issue of Clinical Gastroenterology and Hepatology.

Christoph Engel, M.D., of the University of Leipzig in Germany, and colleagues conducted a prospective, multicenter study to test the efficacy of yearly colonoscopies to detect adenomas and CRC in subjects with HNPCC. The study enrolled 1,126 subjects from three groups of HNPCC families: those with a pathogenic germline mutation in a mismatch repair gene (MUT group); those with microsatellite instability but no mutation (MSI group); and those with at least three relatives with a history of CRC or other HNPCC-related tumors but no microsatellite instability (MSS group).

The researchers note that, at baseline colonoscopies of the 1,126 subjects, 28 CRCs were detected, including 10 that were stage III. In 2,348 follow-up colonoscopies, 43 CRCs were detected and tended to be early stage with only two in stage III. Significantly, 19 of the 43 subjects with CRCs at follow-up had had a normal surveillance colonoscopy within 12 months previously. In analysis by group, CRC risk at the age of 60 years was similar in the MSI and MUT groups (23.0 percent combined) but substantially lower in the MSS group (1.8 percent).

"Annual colonoscopic surveillance is recommended for individuals with HNPCC. Less intense surveillance might be appropriate for MSS families," the authors write.

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