Gastric cancer is highly prevalent in Lynch syndrome patients with atrophic gastritis

Cho, Hourin; Yamada, Masayoshi; Sekine, Shigeki; Tanabe, Noriko; Ushiama, Mineko; Hirata, Makoto; Ogawa, Gakuto; Gotoh, Masahiro; Yoshida, Teruhiko; Yoshikawa, Takaki; Saito, Yutaka; Kuchiba, Aya; Oda, Ichiro; Sugano, Kokichi

doi:10.1007/s10120-020-01113-0

Cited by 13 publications

(11 citation statements)

References 33 publications

(50 reference statements)

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“…Currently, there are formal recommendations for the surveillance of precancerous gastric conditions in general population [10], but no specific recommendations for SL patients. A Japanese study demonstrated that gastric neoplasms occurred significantly more in individuals with gastric atrophy (26/54 vs. 9/53 individuals) [15]. Also, we demonstrated that patients with OLGA III/IV had a higher risk of GC.…”

Section: Discussionsupporting

confidence: 62%

Risk factors for gastric cancer in patients with Lynch syndrome

Ortigão

Brito

Pinto

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Introduction The cumulative lifetime risk of gastric cancer (GC) in patients with Lynch syndrome (LS) is reported to be 8%. There is limited evidence on specific risk factors for GC and no agreement among guidelines on gastric endoscopic surveillance schedule in LS patients. Aims and methods We conducted a retrospective cohort study to identify risk factors for gastric precancerous conditions (chronic atrophic gastritis and intestinal metaplasia) and GC in patients with LS and a case–control study to compare the prevalence of these conditions with a control group. Results We included 385 LS patients (40.5% male, mean age 49.0 years). During a median follow-up period of 48 months (interquartile range, 24–84 months), precancerous conditions were identified in 110 patients (34%) and the prevalence of advanced stages of atrophic gastritis was 3% for OLGA III/IV and 0.6% OLGIM III/IV. Family history of GC was significantly associated with OLGA III/IV (P = 0.020). Among LS patients, 10 patients (2.6%) were diagnosed with GC (incidence rate of 5/1000 persons-year). Older age and OLGA III/IV were identified as risk factors for GC (P < 0.001). When compared with controls, patients with LS had significantly higher rates of Hp infection (P = 0.035) and lower OLGA and OLGIM stages (P < 0.001 and P = 0.026, respectively). Conclusion In our cohort, the incidence of GC and advanced stages of atrophic gastritis was low. Older age and OLGA III/IV were associated with a higher risk of GC. Identification of risk factors for GC in LS patients can help tailoring endoscopic surveillance.

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Section: Discussionsupporting

confidence: 62%

Risk factors for gastric cancer in patients with Lynch syndrome

Ortigão

Brito

Pinto

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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“…17,18,20 All 3 studies assessed MLH1, MSH2, and MSH6 mutation carriers, while 2 studies included PMS2 mutation carriers. 17,18 Gene-specific gastric cancer risks in LS. Two studies assessed cumulative risk of GC in LS individually by MLH1, MSH2, and MSH6.…”

Section: Cumulative Incidencementioning

confidence: 99%

Risk of Gastric Cancer and Utility of Endoscopic Screening for Lynch Syndrome Patients

Bar-Mashiah

Ahsan

McGonigle

et al. 2023

Foregut: The Journal of the American Foregut Society

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Background: Lynch syndrome (LS) is an autosomal dominant hereditary condition associated with a genetic predisposition to several cancers. Prior studies have shown an increased risk of gastric cancer (GC) in LS patients. The aim of this study was to synthesize the evidence for gastric cancer risk across Lynch syndrome-associated mutations and to assess the diagnostic utility of endoscopic screening for gastric cancer in these patients. Methods: A systematic literature review and meta-analysis of LS-associated gastric cancer risk and the diagnostic utility of endoscopic gastric cancer screening was conducted in accordance with PRISMA guidelines and GRADE methodology. Results: The results of this study found an elevated risk of GC in LS patients. Cumulative lifetime risk of GC in LS patients ranged from 2.6% to 38.7% when assessing across all LS mutations. Cumulative incidence ranged from 2.0% to 41.0%. When assessing cumulative incidence across specific LS mutations, MSH2 mutation carriers showed the highest cumulative incidence. RR across specific mutation carriers was generally highest in MSH2 carriers. A meta-analysis of 5 studies reporting diagnostic utility of endoscopic screening for gastric cancer in LS patients revealed a 2% incidence of GC (95% CI, 1.4%−2.9%). Conclusions: Gastric cancer risk in LS patients is greater than in the general population. Endoscopic screening yields low rates of GC in LS patients. Higher quality studies including RCTs are required to more accurately define GC risk and the yield of endoscopic surveillance in LS patients.

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“…Studies of populations with Lynch syndrome in Japan and Korea have reported cumulative incidence of gastric neoplasia (including dysplasia and cancer) as high as 41%, often associated with H. pylori infection. [36][37][38][39] Other patient-specific characteristics associated with greater gastric cancer risk in Lynch syndrome include male sex at birth, older age and having a first-degree relative with gastric cancer. 40…”

Section: Genetics and Gastric Cancer Riskmentioning

confidence: 99%

Endoscopic Surveillance in Patients with the Highest Risk of Gastric Cancer: Challenges and Solutions

Long¹,

Ebrahimzadeh²,

Stanich³

et al. 2022

CMAR

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Gastric cancer is one of the most significant causes of cancer-related morbidity and mortality worldwide. Recognized modifiable risk factors include Helicobacter pylori infection, geographic location, select dietary factors, tobacco use and alcohol consumption. In addition, multiple hereditary cancer predisposition syndromes are associated with significantly elevated gastric cancer risk. Endoscopic surveillance in hereditary gastric cancer predisposition syndromes has the potential to identify gastric cancer at earlier and more treatable stages, as well as to prevent development of gastric cancer through identification of precancerous lesions. However, much uncertainty remains regarding use of endoscopic surveillance in hereditary gastric cancer predisposition syndromes, including whether or not it should be routinely performed, the surveillance interval and age of initiation, cost-effectiveness, and whether surveillance ultimately improves survival from gastric cancer for these high-risk individuals. In this review, we outline the hereditary gastric cancer predisposition syndromes associated with the highest gastric cancer risks. Additionally, we cover current evidence and guidelines addressing hereditary gastric cancer risk and surveillance in these syndromes, along with current challenges and limitations that emphasize a need for continued research in this field.

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Gastric cancer is highly prevalent in Lynch syndrome patients with atrophic gastritis

Cited by 13 publications

References 33 publications

Risk factors for gastric cancer in patients with Lynch syndrome

Risk factors for gastric cancer in patients with Lynch syndrome

Risk of Gastric Cancer and Utility of Endoscopic Screening for Lynch Syndrome Patients

Endoscopic Surveillance in Patients with the Highest Risk of Gastric Cancer: Challenges and Solutions

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