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UEG Standards and Guidelines

Clinical Practice Guideline

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Endoscopic management of Lynch syndrome and of familial risk of colorectal cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Monique van leerdam

Summary

AI Generated

ESGE provides recommendations for colonoscopy surveillance in Lynch syndrome and familial colorectal cancer, including mutation-specific starting ages and use of high-definition endoscopy.

Colonoscopy surveillance should start at age 25 years for MLH1 and MSH2 mutation carriers and at age 35 years for MSH6 and PMS2 mutation carriers in Lynch syndrome
High-definition endoscopy systems are recommended for routine use in individuals with Lynch syndrome
Individuals with Lynch syndrome should be followed in dedicated units that monitor compliance and endoscopic performance measures
Chromoendoscopy may benefit Lynch syndrome patients but routine use must be balanced against costs, training, and practical considerations
Familial risk of colorectal cancer is defined as at least two first-degree relatives with colorectal cancer or at least one first-degree relative diagnosed before age 50 years, warranting colonoscopy surveillance

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Guideline

Main recommendations

ESGE recommends that individuals with Lynch syndrome should be followed in dedicated units that practice monitoring of compliance and endoscopic performance measures.

Strong recommendation, low quality evidence, level of agreement 100 %.

ESGE recommends starting colonoscopy surveillance at the age of 25 years for MLH1 and MSH2 mutation carriers and at the age of 35 years for MSH6 and PMS2 mutation carriers.

Strong recommendation, moderate quality evidence, level of agreement 100 %.

ESGE recommends the routine use of high-definition endoscopy systems in individuals with Lynch syndrome.

Strong recommendation, high quality evidence, level of agreement 100 %.

ESGE suggests the use of chromoendoscopy may be of benefit in individuals with Lynch syndrome undergoing colonoscopy; however routine use must be balanced against costs, training, and practical considerations.

Weak recommendation, moderate quality evidence, level of agreement 89%.

ESGE recommends definition of familial risk of colorectal cancer as the presence of at least two first-degree relatives with colorectal cancer or at least one first-degree relative with colorectal cancer before the age of 50 years.

Strong recommendation, moderate quality evidence, level of agreement 92%.

ESGE recommends colonoscopy surveillance in first-degree relatives of colorectal cancer patients in families that fulfill the definition of familial risk of colorectal cancer.

Strong recommendation, moderate quality evidence, level of agreement 100 %.

Publisher

European Society of Gastrointestinal Endoscopy

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Endoscopy

Citation

Endoscopy. 2019 Nov;51(11):1082-1093

Published

2019

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IMPACT OF FIRST AND FURTHER DECOMPENSATION IN METABOLIC-DYSFUNCTION ASSOCIATED COMPENSATED ADVANCED CHRONIC LIVER DISEASE

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IMPACT OF FIRST AND FURTHER DECOMPENSATION IN METABOLIC-DYSFUNCTION ASSOCIATED COMPENSATED ADVANCED CHRONIC LIVER DISEASE

Grazia Pennisi 1, Gabriele Di Maria 2, Vincent Wai Sun Wong 3, Victor De Ledinghen 4, Giada Sebastiani 5, Mauro Vigano 6, Anna Francanzani 7, Luca Miele 8, Elisabetta Bugianesi 9, Mattias Ekstedt 10, Roberta D'Ambrosio 11, Federico Ravaioli 12, Filippo Schepis 13, Fabio Marra 14, Alessio Aghemo 15, Gianluca Svegliati Baroni 16, Marcello Persico 17, Luca Valenti 6, Annalisa Berzigotti 18, Jacob George 19, Angelo Armandi 20, Patrik Nasr 10, Stergios Kechagias 10, Antonio Liguori 21, Dario Saltini 13, YULY PAULIN MENDOZA JAIMES 22, Vincenza Calvaruso 2, Marco Enea 2, Huapeng Lin 23, Giuseppe Infantino 2, Mario Masarone 17, Nicola Pugliese 24, Adele Tulone 2, Vito Di Marco 2, Calogero Camma 25, Salvatore Petta 26

Affiliations

1 Policlinico Paolo Giaccone, Palermo, Italy

2 University of Palermo, Palermo, Italy

3 University of Hong Kong, Hong Kong, China

4 Bordeaux University Hospital, Pessac, France

5 McGill University Health Centre, Montreal, Canada

6 University of Milan, Milan, Italy

7 Università degli Studi di Milano, Fondazione Ospedale Policlinico Ca Granda IRCCS, Milan, Italy

8 Fondazione Policlinico Gemelli IRCCS, Università Cattolica S. Cuore, Rome, Italy

9 AOU Città della Salute e della Scienza University of Torino, Torino, Italy, Torino, Italy

10 Linköping University, Linköping, Sweden

11 Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

12 University of Bologna, Bologna, Italy

13 University of Modena, Modena, Italy

14 University of Florence, Florence, Italy

15 Humanitas University, Pieve Emanuele, Italy

16 Università Politecnica delle Marche, Ancona, Italy

17 University of Salerno, Salerno, Italy

18 Inselspital, University Hospital of Berne, Berne, Switzerland

19 University of Sydney, Sidney, Italy

20 University of Turin, Torino, Italy

21 Catholic University Of Sacred Heart, Rome, Rome, Italy

22 Inselspital, DBMR, university of Berm, Bern, Switzerland

23 The Chinese University of Hong Kong, Hong Kong, Italy

24 Istituto Clinico Humanitas IRCCS, Rozzano, Italy

25 UOC Gastroenterologia Ed Epatologia, Palermo, Italy

26 University of Palermo Italy 48.37, Palermo, Italy