Screening Significantly Reduces Cancer Deaths in Families with Hereditary Lynch Syndrome
(Shift in Mortality in Lynch Syndrome Families Due to Surveillance, de Jong et al.)
Families with a history of Lynch syndrome who are screened regularly reduce their risk of death by 70 percent, according to a study published in the journal Gastroenterology. Lynch Syndrome, also known as hereditary non-polyposis colorectal cancer, is a rare hereditary disorder that usually causes the development of colorectal, endometrial and other forms of cancer. People with the syndrome have a nearly 90 percent risk of developing some form of cancer throughout their lifetime.
Researchers in the Netherlands conducted a study to evaluate the effectiveness of a screening program to look at the prevalence and mortality rates of Lynch Syndrome on a large scale. The program was established in 1987 to promote the early detection of cancer in high-risk families in the Netherlands. The study involved 140 families (2,788 individuals) known to be carriers of the syndrome. Findings show that nearly 75 percent of all deaths in these families were due to cancer, 50 percent of which were from colorectal cancer. Furthermore, there was a 70 percent decrease in the risk of dying from bowel cancer following the establishment of the registry (observed between 1990 and 2004) and screening program.
These findings are important for all patients who are predisposed to develop a hereditary form of bowel cancer because they show that periodic screening by colonoscopy is very effective and has the potential to prevent a majority of deaths from colorectal cancer. Researchers are hopeful that these findings will encourage those with Lynch Syndrome to participate in screening programs and encourage health-care providers to put more emphasis on taking the family history of all patients affected with cancer.
People with IBD-Related CRC Have Similar Prognosis as General Population with CRC
(Colorectal Cancer Prognosis Among Patients with Inflammatory Bowel Disease, Delaunoit et al.)
Historically, it has been thought that people with inflammatory bowel disease (IBD) are at a significantly higher risk of developing and dying from colorectal cancer than those who develop it sporadically. However, findings of a study published in the journal Clinical Gastroenterology and Hepatology show that people with IBD-related colorectal cancer survive just as long as with the disease as those without IBD. Typically, those with IBD have a more advanced form of colorectal cancer when diagnosed and have more cancerous tumors present.
Researchers from the Mayo Clinic in Rochester, MN conducted a study to compare the survival rates of subjects with IBD-related colorectal cancer to those who developed the disease sporadically. Study participants (n = 290 with IBD and 290 without IBD) were gathered from a review of existing medical records at the Mayo Clinic of patients diagnosed with colorectal cancer between 1976 and 1996. The study found that IBD patients were diagnosed with colorectal cancer at a relatively young age and that their tumors tend to be more evenly distributed throughout the colon and rectum than those who develop the disease sporadically. Survival rates for the disease were similar for those with IBD and without, 55 percent and 53 percent respectively.
Researchers urge patients with IBD and their health-care providers to discuss the potential risks of developing colorectal cancer and implement a surveillance program to monitor their disease, if necessary. The earlier the stage of the disease when it is diagnosed, the better the prognosis or survival outcome, say study authors.
Self-Propelling, Self-Navigating Mini-Endoscope May be Effective for CRC Screening
(The Aer-O-Scope: Proof of Concept of A Pneumatic, Skill-Independent, Self-Propelling, Self-Navigating Colonoscope, Vucelic et al.)
According to a study in this month’s issue of Gastroenterology, a self-propelling, self-navigating device called the Aer-O-Scope was found to be as effective as standard colonoscopes in moving throughout the colon. The device also proved efficient without the need for the sedation that is normally required during traditional colonoscopy in more than 80 percent of those people studied.
Researchers from the United States, Croatia and Israel conducted a study that involved 12 young, healthy volunteers between the ages of 20 and 43 who underwent examination with the Aer-O-Scope technology. Each participant underwent a complete bowel cleansing before the procedure and a standard colonoscopy following the procedure to ensure safety and detect any potential internal bleeding. The procedure proved to be effective (navigation through the entire colon was achieved in 83 percent of the patients), time-efficient (time for each procedure ranged between 15 and 35 minutes) and safe (no patients experienced significant adverse events).
According to these researchers, patients who tolerate the procedure without sedation can expect to leave the procedure and resume their daily activity, avoid the need to have a family member or friend drive them home and may avoid the potential risks and costs of conscious or unconscious sedation. More information on colorectal cancer is available at www.gastro.org.
About Colorectal Cancer Screening
Guidelines of multiple agencies and professional societies underscore the importance of screening for all individuals 50 years of age and older. Currently, there are a number of tests that may be used to screen for colorectal cancer, the second-leading cancer killer in the United States. Approved tests include barium enema, fecal occult blood test, flexible sigmoidoscopy and colonoscopy. Each screening option has advantages and disadvantages, and patients should consult their physician on the most appropriate test.
About the AGA
The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is the oldest medical-specialty society in the United States. Comprised of two non-profit organizations--the AGA and the AGA Institute--our more than 14,500 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization's practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization's annual meeting is Digestive Disease Week®, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
About Gastroenterology
Gastroenterology, the official journal of the AGA, is the most prominent journal in the subspecialty and is in the top one percent of indexed medical journals internationally. The journal publishes clinical and basic studies of all aspects of the digestive system, including the liver and pancreas, as well as nutrition. The journal is abstracted and indexed in Biological Abstracts, CABS, Chemical Abstracts, Current Contents, Excerpta Medica, Index Medicus, Nutrition Abstracts and Science Citation Index. For more information, visit www.gastrojournal.org.
About Clinical Gastroenterology and Hepatology
The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit www.cghjournal.org.
Journal
GASTROENTEROLOGY