Endoscopic screening for upper gastrointestinal cancers can detect malignancies and precancerous lesions in patients with Lynch syndrome. This is the conclusion of researchers from the universities of Florida and Pennsylvania after a meta-analysis of several studies using this screening.
Patients with Lynch syndrome (LS) have a lifelong risk of malignancies, including colorectal, endometrial, gastric, and duodenal cancers. The role of upper gastrointestinal cancer screening is still unclear, but has been studied in recent studies. American researchers have made a meta-analysis of this. They searched for studies with endoscopic screening via esophagogastroduodenoscopy (EGD) and calculated event rates for the detection of gastric and duodenal cancers, high-risk lesions, and clinically relevant outcomes.
The researchers found 9 studies, with 2,356 LS patients having experienced more than 7,800 EGDs. We identified 47 LS-associated tumors (18 gastric and 29 duodenal), 237 high-risk lesions, and 335 clinically relevant findings. The pooled event rate for detection of any upper gastrointestinal cancer, high-risk lesion, and clinically relevant finding during screening was 0.9, 4.2, and 6.2%, respectively.
The researchers conclude that there is evidence that endoscopic screening in LS patients can detect upper gastrointestinal tumors, precancerous lesions, and other clinically relevant abnormalities. This supports the use of such screening as part of risk management for malignancies in Lynch syndrome.
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