Endoscopic management of Lynch syndrome and of familial risk of colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Monique E. van Leerdam; Victorine H. Roos; Jeanin E. van Hooft; Francesc Balaguer; Evelien Dekker; Michal F. Kaminski; Andrew Latchford; Helmut Neumann; Luigi Ricciardiello; Maria Rupińska; Jean-Christophe Saurin; Pieter J. Tanis; Anja Wagner; Rodrigo Jover; Maria Pellisé

doi:10.1055/a-1016-4977

Endoscopy, Table of Contents

Endoscopy 2019; 51(11): 1082-1093
DOI: 10.1055/a-1016-4977

Guideline

Endoscopic management of Lynch syndrome and of familial risk of colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Monique E. van Leerdam

¹Department of Gastroenterology and Hepatology, Netherlands Cancer Institute, Amsterdam, The Netherlands

²Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands, Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands

,

Victorine H. Roos

³Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands

,

Jeanin E. van Hooft

³Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands

,

Francesc Balaguer

⁴Gastroenterology Department, Hospital Clínic de Barcelona, Barcelona, Spain

⁵Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain

,

Evelien Dekker

³Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands

,

Michal F. Kaminski

⁶Department of Cancer Prevention, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland

⁷Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland

⁸Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

,

Andrew Latchford

⁹Polyposis Registry, St. Mark’s Hospital, Harrow, United Kingdom

¹⁰Department of Surgery and Cancer, Imperial College London, London, United Kingdom

,

Helmut Neumann

¹¹Department of Medicine I, University Medical Center Mainz, Mainz, Germany

,

Luigi Ricciardiello

¹²Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy

,

Maria Rupińska

⁶Department of Cancer Prevention, The Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland

⁷Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland

,

Jean-Christophe Saurin

¹³Gastroenterology and Endoscopy Unit, Hospices Civils de Lyon, Hôpital E. Herriot, Lyon, France

,

Pieter J. Tanis

¹⁴Department of Surgery, Amsterdam University Medical Centers, University of Amsterdam, Cancer Center Amsterdam, , Amsterdam, The Netherlands

,

Anja Wagner

¹⁵Department of Clinical Genetics, Erasmus University Medical Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

,

Rodrigo Jover

¹⁶Department of Gastroenterology, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL, Alicante, Spain

,

Maria Pellisé

⁴Gastroenterology Department, Hospital Clínic de Barcelona, Barcelona, Spain

⁵Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain

› Author Affiliations

Abstract

Main Recommendations

ESGE recommends that individuals with Lynch syndrome should be followed in dedicated units that practice monitoring of compliance and endoscopic performance measures.

Strong recommendation, low quality evidence, level of agreement 100 %.

ESGE recommends starting colonoscopy surveillance at the age of 25 years for MLH1 and MSH2 mutation carriers and at the age of 35 years for MSH6 and PMS2 mutation carriers.

Strong recommendation, moderate quality evidence, level of agreement 100 %.

ESGE recommends the routine use of high-definition endoscopy systems in individuals with Lynch syndrome.

Strong recommendation, high quality evidence, level of agreement 100 %.

ESGE suggests the use of chromoendoscopy may be of benefit in individuals with Lynch syndrome undergoing colonoscopy; however routine use must be balanced against costs, training, and practical considerations.

Weak recommendation, moderate quality evidence, level of agreement 89 %.

ESGE recommends definition of familial risk of colorectal cancer as the presence of at least two first-degree relatives with colorectal cancer or at least one first-degree relative with colorectal cancer before the age of 50 years.

Strong recommendation, moderate quality evidence, level of agreement 92 %.

ESGE recommends colonoscopy surveillance in first-degree relatives of colorectal cancer patients in families that fulfill the definition of familial risk of colorectal cancer.

Strong recommendation, moderate quality evidence, level of agreement 100 %.

Full Text

References

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