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SHR Neuro Cancer Cardio Lipid Metab Microb

Lackner, C; Hoefler, G.
Critical issues in the identification and management of patients with hereditary non-polyposis colorectal cancer.
Eur J Gastroenterol Hepatol. 2005; 17(3):317-322 Doi: 10.1097%2F00042737-200503000-00010 [OPEN ACCESS]
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Leading authors Med Uni Graz
Höfler Gerald
Lackner Karoline
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Abstract:
Inherited defects of the DNA mismatch repair system are the underlying cause of the hereditary non-polyposis colorectal cancer (HNPCC) syndrome and are responsible for 3-4% of all cases of colorectal cancer. The HNPCC syndrome also carries the risk of development of additional malignancies such as endometrial, stomach, small bowel, ovarian, pancreas, ureter, renal pelvis, biliary tract and brain tumours. Amsterdam I and II criteria have been developed to clinically identify affected families. The revised Bethesda criteria function to select patients whose tumours should be investigated for microsatellite instability, the molecular hallmark of defects of the DNA mismatch repair proteins such as hMLH1 and hMSH2. Microsatellite instability-positive cases should be investigated for germline defects in the respective genes. This facilitates identification of affected family members that have to be included in special surveillance programmes, while unaffected family members are spared the physical discomfort and psychological burden of cancer surveillance. In this article, strategies for effective clinical as well as genetic detection of affected individuals, surveillance and appropriate preventive measures are discussed. Open questions include the role of chemoprevention, preventive surgical procedures, new endoscopic procedures as well as non-invasive 'virtual colonoscopy' and the exact implications of some mutations of the DNA mismatch repair genes. Perhaps most importantly, efforts should be made to more efficiently transfer information about the HNPCC syndrome and the cancer risk associated with it from the specialists to primary health care providers and the general public.
Find related publications in this database (using NLM MeSH Indexing)
Base Pair Mismatch - genetics
Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis
DNA Repair - genetics
DNA, Neoplasm - genetics
Family Health - genetics
Genetic Screening - methods
Heterozygote - methods
Humans - methods
Microsatellite Repeats - genetics

Find related publications in this database (Keywords)
colorectal cancer
hereditary non-polyposis colon cancer
hereditary
DNA mismatch repair
microsatellite instability
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