Hereditary nonpolyposis colorectal cancer: results of long-term surveillance in 50 families

H. F A Vasen, B. G. Taal, F. M. Nagengast, G. Griffioen, F. H. Menko, J. H. Kleibeuker, G. J A Offerhaus, P. Meera Khan

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74 Scopus citations


A surveillance programme comprising either colonoscopy or sigmoidoscopy plus barium enema every 2-3 years was instituted in 50 hereditary nonpolyposis colorectal cancer (HNPCC) families. The families included 238 patients with colorectal cancer (CRC) (mean age at diagnosis: 43.7 years; range: 16-86 years). These patients had 597 first-degree relatives of whom 493 could be traced and 388 (79%) accepted the invitation for screening. The control group were relatives (index patients) with symptomatic CRC. The average follow-up duration was 5 years (1-20 years). Screening led to the detection of adenomas in 33 patients and CRC in 11 patients. Pathological examination revealed 1 Dukes' A, 7 Dukes' B and 3 Dukes' C cancers. In contrast, among the control group 47% had advanced CRC (Dukes' C or distant metastases). The 5-year survival of the screen-detected cases was 87% versus 63% in the control group. Of the 11 CRC cases in the screening group, 4 were detected within 1-4 years after a negative colonic examination. A large proportion of the polyps found in the screening and control groups showed a villous growth pattern and/or a high degree of dysplasia. We conclude that periodic examination of HNPCC families allows the detection of cancer at an earlier stage than in patients not under surveillance. Because of the possibly more aggressive nature of polyps associated with HNPCC, we recommend a screening interval of 1-2 years.

Original languageEnglish (US)
Pages (from-to)1145-1148
Number of pages4
JournalEuropean Journal of Cancer
Issue number7-8
StatePublished - 1995
Externally publishedYes


  • adenomas
  • hereditary non-polyposis colorectal cancer
  • Lynch syndrome
  • surveillance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Hematology


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