%0 Journal Article %1 Engel.2010 %A Engel, Christoph %A Rahner, Nils %A Schulmann, Karsten %A Holinski-Feder, Elke %A Goecke, Timm O. %A Schackert, Hans K. %A Kloor, Matthias %A Steinke, Verena %A Vogelsang, Holger %A Möslein, Gabriela %A Görgens, Heike %A Dechant, Stefan %A von Knebel Doeberitz, Magnus, %A Rüschoff, Josef %A Friedrichs, Nicolaus %A Büttner, Reinhard %A Loeffler, Markus %A Propping, Peter %A Schmiegel, Wolff %D 2010 %J Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association %K Adult Aged Aged,_80_and_over Cohort_Studies Colonoscopy Colorectal_Neoplasms,_Hereditary_Nonpolyposis/diagnosis Early_Detection_of_Cancer/methods Female Health_Services_Research Humans Male Middle_Aged Prospective_Studies Severity_of_Illness_Index %N 2 %P 174–182 %T Efficacy of annual colonoscopic surveillance in individuals with hereditary nonpolyposis colorectal cancer %V 8 %X BACKGROUND & AIMS\r\nIndividuals with hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome) have a high risk for developing colorectal cancer (CRC). We evaluated the efficacy of annual surveillance colonoscopies to detect adenomas and CRCs.\r\nMETHODS\r\nIn a prospective, multicenter cohort study, 1126 individuals underwent 3474 colonoscopies. We considered individuals from 3 groups of HNPCC families: those with a pathogenic germline mutation in a mismatch repair gene (MUT group), those without a mutation but with microsatellite instability (MSI group), and those who fulfilled the Amsterdam criteria without microsatellite instability (MSS group).\r\nRESULTS\r\nCompliance to annual intervals was good, with 81\% of colonoscopies completed within 15 months. Ninety-nine CRC events were observed in 90 patients. Seventeen CRCs (17\%) were detected through symptoms (8 before baseline colonoscopy, 8 at intervals >15 months to the preceding colonoscopy, and 1 interval cancer). Only 2 of 43 CRCs detected by follow-up colonoscopy were regionally advanced. Tumor stages were significantly lower among CRCs detected by follow-up colonoscopies compared with CRCs detected by symptoms (P = .01). Cumulative CRC risk at the age of 60 years was similar in the MUT and MSI groups (23.0\% combined; 95\% confidence interval CI, 14.8\%-31.2\%) but considerably lower in the MSS group (1.8\%; 95\% CI, 0.0\%-5.1\%). Adenomas at baseline colonoscopy predicted an earlier occurrence of subsequent adenoma (hazard ratio, 2.6; 95\% CI, 1.7-4.0) and CRC (hazard ratio, 3.9; 95\% CI, 1.7-8.5), providing information about interindividual heterogeneity of adenomas and kinetics of CRC formation.\r\nCONCLUSIONS\r\nAnnual colonoscopic surveillance is recommended for individuals with HNPCC. Less intense surveillance might be appropriate for MSS families.

@article{Engel.2010, abstract = {BACKGROUND \& AIMS\r\nIndividuals with hereditary nonpolyposis colorectal cancer (HNPCC; Lynch syndrome) have a high risk for developing colorectal cancer (CRC). We evaluated the efficacy of annual surveillance colonoscopies to detect adenomas and CRCs.\r\nMETHODS\r\nIn a prospective, multicenter cohort study, 1126 individuals underwent 3474 colonoscopies. We considered individuals from 3 groups of HNPCC families: those with a pathogenic germline mutation in a mismatch repair gene (MUT group), those without a mutation but with microsatellite instability (MSI group), and those who fulfilled the Amsterdam criteria without microsatellite instability (MSS group).\r\nRESULTS\r\nCompliance to annual intervals was good, with 81\% of colonoscopies completed within 15 months. Ninety-nine CRC events were observed in 90 patients. Seventeen CRCs (17\%) were detected through symptoms (8 before baseline colonoscopy, 8 at intervals >15 months to the preceding colonoscopy, and 1 interval cancer). Only 2 of 43 CRCs detected by follow-up colonoscopy were regionally advanced. Tumor stages were significantly lower among CRCs detected by follow-up colonoscopies compared with CRCs detected by symptoms (P = .01). Cumulative CRC risk at the age of 60 years was similar in the MUT and MSI groups (23.0\% combined; 95\% confidence interval [CI], 14.8\%-31.2\%) but considerably lower in the MSS group (1.8\%; 95\% CI, 0.0\%-5.1\%). Adenomas at baseline colonoscopy predicted an earlier occurrence of subsequent adenoma (hazard ratio, 2.6; 95\% CI, 1.7-4.0) and CRC (hazard ratio, 3.9; 95\% CI, 1.7-8.5), providing information about interindividual heterogeneity of adenomas and kinetics of CRC formation.\r\nCONCLUSIONS\r\nAnnual colonoscopic surveillance is recommended for individuals with HNPCC. Less intense surveillance might be appropriate for MSS families.}, added-at = {2014-10-14T15:27:56.000+0200}, author = {Engel, Christoph and Rahner, Nils and Schulmann, Karsten and Holinski-Feder, Elke and Goecke, Timm O. and Schackert, Hans K. and Kloor, Matthias and Steinke, Verena and Vogelsang, Holger and Möslein, Gabriela and Görgens, Heike and Dechant, Stefan and {von Knebel Doeberitz, Magnus} and Rüschoff, Josef and Friedrichs, Nicolaus and Büttner, Reinhard and Loeffler, Markus and Propping, Peter and Schmiegel, Wolff}, biburl = {https://www.bibsonomy.org/bibtex/2930a64abfbba9d1b4246251f4f661297/drtester}, interhash = {7defce4428445758e1de6ab9b1ba3631}, intrahash = {930a64abfbba9d1b4246251f4f661297}, journal = {Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association}, keywords = {Adult Aged Aged,_80_and_over Cohort_Studies Colonoscopy Colorectal_Neoplasms,_Hereditary_Nonpolyposis/diagnosis Early_Detection_of_Cancer/methods Female Health_Services_Research Humans Male Middle_Aged Prospective_Studies Severity_of_Illness_Index}, number = 2, pages = {174–182}, timestamp = {2014-10-14T15:27:56.000+0200}, title = {Efficacy of annual colonoscopic surveillance in individuals with hereditary nonpolyposis colorectal cancer}, volume = 8, year = 2010 }