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The “unnatural” history of colorectal cancer in Lynch syndrome: Lessons from colonoscopy surveillance
Author(s) -
Ahadova Aysel,
Seppälä Toni T.,
Engel Christoph,
Gallon Richard,
Burn John,
HolinskiFeder Elke,
SteinkeLange Verena,
Möslein Gabriela,
Nielsen Maartje,
Broeke Sanne W.,
Laghi Luigi,
DominguezValentin Mev,
Capella Gabriel,
Macrae Finlay,
Scott Rodney,
Hüneburg Robert,
Nattermann Jacob,
Hoffmeister Michael,
Brenner Hermann,
Bläker Hendrik,
Knebel Doeberitz Magnus,
Sampson Julian R.,
Vasen Hans,
Mecklin JukkaPekka,
Møller Pål,
Kloor Matthias
Publication year - 2020
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.33224
Subject(s) - colonoscopy , colorectal cancer , lynch syndrome , medicine , polypectomy , adenoma , cancer , epidemiology , oncology , dna mismatch repair
Individuals with Lynch syndrome (LS), one of the most common inherited cancer syndromes, are at increased risk of developing malignancies, in particular colorectal cancer (CRC). Regular colonoscopy with polypectomy is recommended to reduce CRC risk in LS individuals. However, recent independent studies demonstrated that a substantial proportion of LS individuals develop CRC despite regular colonoscopy. The reasons for this surprising observation confirmed by large prospective studies are a matter of debate. In this review, we collect existing evidence from clinical, epidemiological and molecular studies and interpret them with regard to the origins and progression of LS‐associated CRC. Alongside with hypotheses addressing colonoscopy quality and pace of progression from adenoma to cancer, we discuss the role of alternative precursors and immune system in LS‐associated CRC. We also identify gaps in current knowledge and make suggestions for future studies aiming at improved CRC prevention for LS individuals.

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