Lynch syndrome family members have a high risk of developing colorectal, endometrial, and other cancers.
A large-scale surveillance program was introduced in The Netherlands in the late 1980s.
Dr Andrea de Jong and colleagues evaluated the effectiveness of this program.
The investigative team assessed colorectal and endometrial cancer mortality before and after 1990.
The investigators also compared mortality because of all cancers with mortality in the general population.
Family members with at least 50% probability of being a carrier were selected for the study.
The standardized mortality ratio because of cancer and the absolute excess risk of death were calculated.
|The most frequent cause of cancer-related deaths was colorectal cancer in 50%|
The investigators found, that of a total cohort of 2788 patients, 445 subjects had died because of cancer.
The 3 most frequent causes of cancer-related deaths were colorectal cancer in 50%, endometrial cancer in 7 %, and brain tumors in 6 %.
The team observed a significant decrease of 70% in standardized mortality ratio for colorectal cancer over time.
The standardized mortality ratio for endometrial cancer showed no decreasing trend over time.
A significantly increased standardized mortality ratio was found for cancer of the small bowel, brain, kidney/ureter, ovarium, pancreas, and stomach.
The investigators noted that the absolute excess risk was significantly increased for brain tumors only.
Dr de Jong's team concluded, “Since the introduction of surveillance, the mortality because of colorectal cancer has decreased.”
“Except for brain tumors, we did not find a significantly increased absolute excess risk for tumors other than colorectal and endometrial cancer."