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Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network

BACKGROUND: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. METHODS: All LS patients followed at our i...

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Autores principales: Perrod, Guillaume, Samaha, Elia, Rahmi, Gabriel, Khater, Sherine, Abbes, Leila, Savale, Camille, Perkins, Geraldine, Zaanan, Aziz, Chatellier, Gilles, Malamut, Georgia, Cellier, Christophe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974573/
https://www.ncbi.nlm.nih.gov/pubmed/29872454
http://dx.doi.org/10.1177/1756284818775058
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author Perrod, Guillaume
Samaha, Elia
Rahmi, Gabriel
Khater, Sherine
Abbes, Leila
Savale, Camille
Perkins, Geraldine
Zaanan, Aziz
Chatellier, Gilles
Malamut, Georgia
Cellier, Christophe
author_facet Perrod, Guillaume
Samaha, Elia
Rahmi, Gabriel
Khater, Sherine
Abbes, Leila
Savale, Camille
Perkins, Geraldine
Zaanan, Aziz
Chatellier, Gilles
Malamut, Georgia
Cellier, Christophe
author_sort Perrod, Guillaume
collection PubMed
description BACKGROUND: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. METHODS: All LS patients followed at our institution were consecutively included in the Prédisposition au Cancer Colorectal-Ile de France (PRED-IdF) network. Patients were offered an optimized screening program allowing an adjustment of the interval between colonoscopies, depending on bowel preparation, chromoendoscopy achievement and adenoma detection. Colonoscopies were defined as optimal when all the screening criteria were respected. We compared colonoscopy quality and colonoscopy detection rate before and after PRED-IdF inclusion, including polyp detection rate (PDR), adenoma detection rate (ADR) and cancer detection rate (CDR). RESULTS: Between January 2010 and January 2016, 144 LS patients were consecutively included (male/female = 50/94, mean age = 51 ± 13 years and mutations: MLH1 = 39%, MSH2 = 44%, MSH6 = 15%, PMS2 = 1%). A total of 564 colonoscopies were analyzed, 353 after inclusion and 211 before. After PRED-IdF inclusion, 98/144 (68%) patients had optimal screening colonoscopies versus 33/132 (25%) before (p < 0.0005). The optimal colonoscopy rate was 304/353 (86%) after inclusion versus 87/211 (41%) before, (p < 0.0001). PRED-IdF inclusion was associated with a reduction of CRC occurrence with a CDR of 1/353 (0.3%) after inclusion versus 6/211 (2.8%) before (p = 0.012). ADR and PDR were 99/353 (28%) versus 60/211 (28.8%) (p > 0.05) and 167/353 (48.1%) versus 90/211 (42.2%) (p > 0.05), respectively after and before inclusion. CONCLUSIONS: An optimized colonoscopic surveillance program in LS patients seems to improve colonoscopic screening quality and might possibly decrease colorectal interval cancer occurrence. Long-term cohort studies are needed to confirm these results.
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spelling pubmed-59745732018-06-05 Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network Perrod, Guillaume Samaha, Elia Rahmi, Gabriel Khater, Sherine Abbes, Leila Savale, Camille Perkins, Geraldine Zaanan, Aziz Chatellier, Gilles Malamut, Georgia Cellier, Christophe Therap Adv Gastroenterol Original Research BACKGROUND: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. METHODS: All LS patients followed at our institution were consecutively included in the Prédisposition au Cancer Colorectal-Ile de France (PRED-IdF) network. Patients were offered an optimized screening program allowing an adjustment of the interval between colonoscopies, depending on bowel preparation, chromoendoscopy achievement and adenoma detection. Colonoscopies were defined as optimal when all the screening criteria were respected. We compared colonoscopy quality and colonoscopy detection rate before and after PRED-IdF inclusion, including polyp detection rate (PDR), adenoma detection rate (ADR) and cancer detection rate (CDR). RESULTS: Between January 2010 and January 2016, 144 LS patients were consecutively included (male/female = 50/94, mean age = 51 ± 13 years and mutations: MLH1 = 39%, MSH2 = 44%, MSH6 = 15%, PMS2 = 1%). A total of 564 colonoscopies were analyzed, 353 after inclusion and 211 before. After PRED-IdF inclusion, 98/144 (68%) patients had optimal screening colonoscopies versus 33/132 (25%) before (p < 0.0005). The optimal colonoscopy rate was 304/353 (86%) after inclusion versus 87/211 (41%) before, (p < 0.0001). PRED-IdF inclusion was associated with a reduction of CRC occurrence with a CDR of 1/353 (0.3%) after inclusion versus 6/211 (2.8%) before (p = 0.012). ADR and PDR were 99/353 (28%) versus 60/211 (28.8%) (p > 0.05) and 167/353 (48.1%) versus 90/211 (42.2%) (p > 0.05), respectively after and before inclusion. CONCLUSIONS: An optimized colonoscopic surveillance program in LS patients seems to improve colonoscopic screening quality and might possibly decrease colorectal interval cancer occurrence. Long-term cohort studies are needed to confirm these results. SAGE Publications 2018-05-27 /pmc/articles/PMC5974573/ /pubmed/29872454 http://dx.doi.org/10.1177/1756284818775058 Text en © The Author(s), 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Perrod, Guillaume
Samaha, Elia
Rahmi, Gabriel
Khater, Sherine
Abbes, Leila
Savale, Camille
Perkins, Geraldine
Zaanan, Aziz
Chatellier, Gilles
Malamut, Georgia
Cellier, Christophe
Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title_full Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title_fullStr Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title_full_unstemmed Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title_short Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
title_sort impact of an optimized colonoscopic screening program for patients with lynch syndrome: 6-year results of a specialized french network
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974573/
https://www.ncbi.nlm.nih.gov/pubmed/29872454
http://dx.doi.org/10.1177/1756284818775058
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