TY - JOUR
T1 - Systematic review
T2 - non-endoscopic surveillance for colorectal neoplasia in individuals with Lynch syndrome
AU - van Liere, Elsa L S A
AU - de Boer, Nanne K H
AU - Dekker, Evelien
AU - van Leerdam, Monique E
AU - de Meij, Tim G J
AU - Ramsoekh, Dewkoemar
N1 - Funding Information: We would like to thank Marijke A.E. Mol, an information specialist at the Vrije Universiteit Amsterdam, for her aid in developing and performing the systematic literature search in MEDLINE and Embase. Declaration of personal interests: EvL and MvL have nothing to declare. NdB has served as a speaker for AbbVie and MSD and has served as a consultant and principal investigator for TEVA Pharma BV and Takeda. He has received a research grant (unrestricted) from Dr. Falk, TEVA Pharma BV, Dutch Digestive Foundation (MLDS) and Takeda. ED has endoscopic equipment on a loan from FujiFilm and Olympus and has received a research grant from FujiFilm. She has received an honourarium for a consultancy from FujiFilm, Olympus, GI Supply, CPP-FAP, PAION and Ambu and speakers? fees from Olympus, Roche, GI Supply, Norgine, IPSEN, PAION and FujiFilm. TdM has served as a speaker for Nutricia, Mead Johnson and Winclove. He has served as an advisory board member for Nutricia. DR has received a research grant (unrestricted) from AbbVie and is a member of the Data Safety Monitoring Board of Vivoryon Therapeutics. Funding Information: EvL and MvL have nothing to declare. NdB has served as a speaker for AbbVie and MSD and has served as a consultant and principal investigator for TEVA Pharma BV and Takeda. He has received a research grant (unrestricted) from Dr. Falk, TEVA Pharma BV, Dutch Digestive Foundation (MLDS) and Takeda. ED has endoscopic equipment on a loan from FujiFilm and Olympus and has received a research grant from FujiFilm. She has received an honourarium for a consultancy from FujiFilm, Olympus, GI Supply, CPP‐FAP, PAION and Ambu and speakers’ fees from Olympus, Roche, GI Supply, Norgine, IPSEN, PAION and FujiFilm. TdM has served as a speaker for Nutricia, Mead Johnson and Winclove. He has served as an advisory board member for Nutricia. DR has received a research grant (unrestricted) from AbbVie and is a member of the Data Safety Monitoring Board of Vivoryon Therapeutics. Declaration of personal interests: Publisher Copyright: © 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
PY - 2022/4
Y1 - 2022/4
N2 - BACKGROUND: Individuals with Lynch syndrome are at high risk for colorectal cancer (CRC). Regular colonoscopies have proven to decrease CRC incidence and mortality. However, colonoscopy is burdensome and interval CRCs still occur. Hence, an accurate, less-invasive screening method that guides the timing of colonoscopy would be of important value.AIM: To outline the performance of non-endoscopic screening modalities for Lynch-associated CRC and adenomas.METHODS: Systematic literature search in MEDLINE and EMBASE to identify studies investigating imaging techniques and biomarkers for detection of CRC and adenomas in Lynch syndrome. The QUADAS-2 tool was used for the quality assessment of included studies.RESULTS: Seven of 1332 screened articles fulfilled the inclusion criteria. Two studies evaluated either CT colonography or MR colonography; both techniques were unable to detect CRC and (advanced) adenomas <10 mm. The other five studies evaluated plasma methylated-SEPTIN9, faecal immunochemical test (FIT), faecal tumour DNA markers (BAT-26, hMLH1, p53, D9S171, APC, D9S162, IFNA and DCC) and faecal microbiome as screening modalities. Sensitivity for CRC varied from 33% (BAT-26) to 70% (methylated-SEPTIN9) to 91% (hMLH1). High specificity (94-100%) for CRC and/or adenomas was observed for methylated-SEPTIN9, FIT and BAT-26. Desulfovibrio was enriched in the stool of patients having adenomas. However, all these studies were characterised by small populations, high/unclear risk of bias and/or low prevalence of adenomas.CONCLUSIONS: Imaging techniques are unsuitable for colon surveillance in Lynch syndrome, whereas biomarkers are understudied. Having outlined biomarker research in Lynch-associated and sporadic CRC/adenomas, we believe that these non-invasive markers may hold potential (whether or not combined) for this population. As they could be of great value, (pre-)clinical studies in this field should be prioritised.
AB - BACKGROUND: Individuals with Lynch syndrome are at high risk for colorectal cancer (CRC). Regular colonoscopies have proven to decrease CRC incidence and mortality. However, colonoscopy is burdensome and interval CRCs still occur. Hence, an accurate, less-invasive screening method that guides the timing of colonoscopy would be of important value.AIM: To outline the performance of non-endoscopic screening modalities for Lynch-associated CRC and adenomas.METHODS: Systematic literature search in MEDLINE and EMBASE to identify studies investigating imaging techniques and biomarkers for detection of CRC and adenomas in Lynch syndrome. The QUADAS-2 tool was used for the quality assessment of included studies.RESULTS: Seven of 1332 screened articles fulfilled the inclusion criteria. Two studies evaluated either CT colonography or MR colonography; both techniques were unable to detect CRC and (advanced) adenomas <10 mm. The other five studies evaluated plasma methylated-SEPTIN9, faecal immunochemical test (FIT), faecal tumour DNA markers (BAT-26, hMLH1, p53, D9S171, APC, D9S162, IFNA and DCC) and faecal microbiome as screening modalities. Sensitivity for CRC varied from 33% (BAT-26) to 70% (methylated-SEPTIN9) to 91% (hMLH1). High specificity (94-100%) for CRC and/or adenomas was observed for methylated-SEPTIN9, FIT and BAT-26. Desulfovibrio was enriched in the stool of patients having adenomas. However, all these studies were characterised by small populations, high/unclear risk of bias and/or low prevalence of adenomas.CONCLUSIONS: Imaging techniques are unsuitable for colon surveillance in Lynch syndrome, whereas biomarkers are understudied. Having outlined biomarker research in Lynch-associated and sporadic CRC/adenomas, we believe that these non-invasive markers may hold potential (whether or not combined) for this population. As they could be of great value, (pre-)clinical studies in this field should be prioritised.
KW - Adenoma/diagnosis
KW - Biomarkers, Tumor
KW - Colonoscopy/methods
KW - Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis
KW - Colorectal Neoplasms/diagnosis
KW - Early Detection of Cancer/methods
KW - Humans
KW - Occult Blood
UR - http://www.scopus.com/inward/record.url?scp=85125762476&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/apt.16824
DO - https://doi.org/10.1111/apt.16824
M3 - Review article
C2 - 35181895
SN - 0269-2813
VL - 55
SP - 778
EP - 788
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
IS - 7
ER -