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    The "unnatural" history of colorectal cancer in Lynch syndrome: Lessons from colonoscopy surveillance

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    Author
    Ahadova, A; Seppala, TT; Engel, C; Gallon, R; Burn, J; Holinski-Feder, E; Steinke-Lange, V; Moeslein, G; Nielsen, M; ten Broeke, SW; ...
    Date
    2020-08-03
    Source Title
    International Journal of Cancer
    Publisher
    WILEY
    University of Melbourne Author/s
    Macrae, Finlay
    Affiliation
    Medicine and Radiology
    Metadata
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    Document Type
    Journal Article
    Citations
    Ahadova, A., Seppala, T. T., Engel, C., Gallon, R., Burn, J., Holinski-Feder, E., Steinke-Lange, V., Moeslein, G., Nielsen, M., ten Broeke, S. W., Laghi, L., Dominguez-Valentin, M., Capella, G., Macrae, F., Scott, R., Hueneburg, R., Nattermann, J., Hoffmeister, M., Brenner, H. ,... Kloor, M. (2020). The "unnatural" history of colorectal cancer in Lynch syndrome: Lessons from colonoscopy surveillance. INTERNATIONAL JOURNAL OF CANCER, 148 (4), pp.800-811. https://doi.org/10.1002/ijc.33224.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/252503
    DOI
    10.1002/ijc.33224
    Abstract
    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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