Abstract

MAO DE FERRO, S. et al. Programa de vigilância em famílias com Síndroma de Lynch : a eficácia da medicina preventiva . J Port Gastrenterol. [online]. 2006, vol.13, n.6, pp.267-276. ISSN 0872-8178.

Introduction: Hereditary non-polyposys colorectal cancer (HNPCC) syndrome confers a high risk of colorectal cancer (CRC) development. Colonoscopic surveillance is effective in preventing mortality from CRC. Aims: To evaluate the incidence and prevalence of colorectal tumours in asymptomatic individuals with HNPCC who undergo screening colonoscopies. Methods: 165 asymptomatic individuals divided in 3 groups. GI- MMR mutation (n=33), GII- Amsterdam Criteria (n=95), GIII- Amsterdam criteria except for older age at onset (n=35). Surveillance was performed annually for GI and every 2 years for GII and GIII. Results: In the first colonoscopy we detected adenomas in 26 (15.8%) patients. Adenoma detection was associated only with older age (p=0.02). Patients from GI and GII were more likely to have proximal lesions (p=0.05). Seven (4.2%) patients had CRC (G1=3, GII=3, GIII=1; mean age: 45 years - range: 31-71): four T1N0M0, two T3N0M0 and one T3N2M1. Seventy-seven individuals had follow-up colonoscopies. We detected adenomas in 13 (23.4%) patients - an incidence of 0.13 adenomas/individual/year. No CRC was detected at follow up, nor did interval cancers occur. Conclusions: Asymptomatic individuals with a family history of CRC present a high incidence and prevalence and a young onset of colorectal tumours. Families that do not fulfil the Amsterdam criteria due to late age at onset seem to benefit from the same surveillance that is applied to patients with HNPCC.

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