Endoscopy 2020; 52(S 01): S7
DOI: 10.1055/s-0040-1704031
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 10:30 – 12:00 Colorectal Cancer (CRC) Screening (WEO-ESGE joint session) Ecocem Room
© Georg Thieme Verlag KG Stuttgart · New York

POST-COLONOSCOPY COLORECTAL CANCER IN LYNCH SYNDROME IS ASSOCIATED WITH QUALITY ISSUES DURING SURVEILLANCE

A Sanchez Garcia
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
M Navarro
2   Institut Catala d’Oncologia, Hospitalet de Llobregat, Spain
,
VH Roos
3   Amsterdam UMC Universitair Medische Centra, Amsterdam, Netherlands
,
M Pineda
4   Institut Catala d’Oncologia, Barcelona, Spain
,
B Caballol
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
L Moreno
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
T Ocaña
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
F Rodriguez-Moranta
5   Hospital Universitario de Bellvitge, Hospital de Llobregat, Spain
,
L Rodriguez-Alonso
5   Hospital Universitario de Bellvitge, Hospital de Llobregat, Spain
,
TRy Cajal
6   Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
,
G Llort
7   Instituto Oncologico del Valles, Terrasa-Sabadell, Spain
,
MD Pico
8   Hospital General Universitario de Alicante, Alicante, Spain
,
R Jover
8   Hospital General Universitario de Alicante, Alicante, Spain
,
Adria Lopez Fernandez
9   Hospital Universitario Vall d’Hebron, Barcelona, Spain
,
E Martinez de Castro
10   Hospital Universitario Marques de Valdecilla, Santander, Spain
,
MJ Lopez-Arias
10   Hospital Universitario Marques de Valdecilla, Santander, Spain
,
C Alvarez
11   Hospital del Mar, Barcelona, Spain
,
X Bessa
11   Hospital del Mar, Barcelona, Spain
,
L Rivas
12   Complexo Hospitalario Universitario de Orense, Orense, Spain
,
J Cubiella
12   Complexo Hospitalario Universitario de Orense, Orense, Spain
,
D Rodriguez-Alcalde
13   Hospital de Mostoles, Mostoles, Spain,
,
A Dacal
14   Hospital Universitario Lucus Augusti, Lugo, Spain
,
M Herraiz
15   Clinica Universidad de Navarra, Pamplona, Spain
,
C Garau
16   Hospital Universitari de Son Llatzer, Palma de Mallorca, Spain
,
L Bujanda
17   Hospital Universitario de Donostia, Donostia, Spain
,
L Cid
18   Complexo Hospitalario Universitario de Vigo, Vigo, Spain
,
C Poves
19   Hospital Clinico San Carlos, Madrid, Spain
,
M Garzon
20   Hospital Virgen del Rocio, Sevilla, Spain
,
A Pizarro
20   Hospital Virgen del Rocio, Sevilla, Spain
,
I Salces
21   Hospital 12 de Octubre, Madrid, Spain
,
M Ponce
22   Hospital Universitario de la Fe de Valencia, Valencia, Spain
,
M Carrillo-Palau
23   Hospital Universitario de Canarias, La Laguna, Spain
,
E Aguirre
24   Hospital Quironsalud de Zaragoza, Zaragoza, Spain
,
E Saperas
25   Hospital General de Catalunya, Sant Cugat del Valles, Spain
,
A Suarez
26   Hospital Universitario Central de Asturias, Oviedo, Spain
,
V Piñol
27   Hospital Universitari de Girona Dr. Josep Trueta, Girona, Spain
,
S Carballal
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
L Rivero-Sanchez
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
J Balmaña
9   Hospital Universitario Vall d’Hebron, Barcelona, Spain
,
J Brunet
28   Institut Catala d’Oncologia, Girona, Spain
,
A Castells
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
E Dekker
3   Amsterdam UMC Universitair Medische Centra, Amsterdam, Netherlands
,
M Pellise
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
G Capella
4   Institut Catala d’Oncologia, Barcelona, Spain
,
M Serra-Buriel
29   Center for Research in Health and Economics, UPF, Barcelona, Spain
,
L Moreira
1   Hospital Clinic of Barcelona, Barcelona, Spain
,
F Balaguer
1   Hospital Clinic of Barcelona, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims To assess the effect of quality endoscopic factors on the development of PCCRC during surveillance in LS mutation carriers.

    Methods Multicenter study with 25 high-risk CRC clinics from Spain and 1 from The Netherlands. Demographic, genetics, cancer history, and surveillance protocols from patients LS carriers of verified pathogenic mutations(n=1,746) have been prospectively collected between 2015- 2019. For the current analysis, we focused on healthy-carriers(HC) defined as carriers without CRC prior or in the index colonoscopy. To assess the effect of colonoscopy on PCCRC incidence we evaluated the report of every surveillance colonoscopy(n=3,284). We compared colonoscopies previous to PCCRC with colonoscopies of carriers without cancer. Quality colonoscopy parameters(completeness, bowel-preparation, scope definition and enhancement techniques), time-intervals and findings from a previous colonoscopy were analyzed. Multivariate logistic-regression was performed to identify CRC risk factors.

    Results We included 893 HC, 596(63.7%) female, with a median age of 50.5±14.8 years, a median colonoscopy follow-up of 6.3±4.2 years and 4.8±2.7 colonoscopies. The distribution per gene was: 285(31.9%)MLH1, 316(35.4%)MSH2, 212(23.7%) MSH6 and 80(9%) PMS2 carriers. During surveillance 48(5.4%) PCCRC were diagnosed [17(35.4%) MLH1, 24(50%) MSH2, 6(12.5%) MSH6 and 1(2.1%)PMS2]. The mean age at diagnosis was 51.1±10.6 years, the mean follow-up 5.8±5.5 years, 32(66.7%). When analyzing quality colonoscopy indicators, a previous incomplete colonoscopy and previous colonoscopy performed with standard definition appeared as independent risk factors of PCCRC [OR=6.7(95%CI 1.4-33);p0.018 and OR=5.9(95%CI 1.41-25); p0.015]. Besides, an interval between colonoscopies of more than 36 months, or an advanced adenoma in the previous colonoscopy increased more than 4 times the risk of PCCRC[OR=4.1 (95%IC 1.7-9.8);p0.002 and OR=4.16 (95%CI 1.6-10.6);p0.003].

    Conclusions PCCCR incidence is associated with quality issues in LS carriers under surveillance colonoscopy. High quality colonoscopy and appropriate interval (< 36 months) should be strongly advised. Patients with an advanced adenoma may benefit of shorter interval between colonoscopies.


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