Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Abstract

Main RecommendationsESGE recommends that individuals with hereditary gastrointestinal polyposis syndromes should be surveilled in dedicated units that provide monitoring of compliance and endoscopic performance measures. Strong recommendation, moderate quality of evidence, level of agreement 90 %.ESGE recommends performing esophagogastroduodenoscopy, small-bowel examination, and/or colonoscopy earlier than the planned surveillance procedure if a patient is symptomatic. Strong recommendation, low quality of evidence, level of agreement 100 %.

Dye chromoendoscopy leads to a higher adenoma detection in the duodenum and stomach in patients with familial adenomatous polyposis

“…It is important to note that detection of polyps larger than 10 mm leads to a change in clinical decision-making. The European Society for Gastrointestinal Endoscopy (ESGE) recommends performing EMR on all duodenal lesions larger than 10 mm [21]. In our study we detected significantly more adenomas larger than 10 mm using CE compared to WLE (P = 0.0391).…”

SEOM clinical guideline on hereditary colorectal cancer (2019)

“…These PS are very rare with the exception of serrated polyposis syndrome (SPS); the estimated incidence for PTEN hamartoma tumor syndrome is 1 in 200,000-250,000; for Peutz-Jeghers syndrome it is 1 in 250,000; for juvenile polyposis syndrome it is from 1 to 1.6 in 100,000. The SPS prevalence is higher than for other PS, including FAP; overall, its seems lower than 0.09-42 in 10,000 in colonoscopy-based CRC screening programs, but it is considerably higher in positive fecal occult blood test populations, with estimates of 0.34-0.66% or 31-80 in 10,000 [46][47][48][49][50][51]. Sessile serrated polyposis cancer syndrome (SSPCS) is a very rare disorder caused by heterozygous mutation in the RNF43 gene [49].…”

“…The higher prevalence of CRC and serrated polyps in first-degree relatives (FDRs) as compared to the general population supports this theory. Table 3 summarizes the main characteristics and recommendations of surveillance of Adenomatous polyposis, Hamartomatous polyposis and Non-adenomatous PS according to recommendations of the European Society of Gastrointestinal Endoscopy (ESGE) Guideline [46] or, in the rest of the cases, suggested by other referenced authors.…”

Cancer within the family tree: risks, diagnosis and treatment of juvenile polyposis syndrome

“…Current European Society of Gastrointestinal Endoscopy guidelines suggest early screening of the stomach at age 18 years and colon as early as age 12 years, as the single most impacting factor in outcomes of patients and their families. 3 Our patient was referred to general surgery for resection of mass.…”