Colorectal cancer surveillance in Lynch syndrome: quality standards, emerging technology and complementary strategies.
9 affiliations
- 1Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain.
- 2Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- 3Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
- 4Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain.
- 5Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
- 6Department of Gastroenterology, Hospital Clínic de Barcelona, Barcelona, Spain. [email protected].
- 7Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. [email protected].
- 8Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. [email protected].
- 9Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain. [email protected].
Abstract
Lynch syndrome is the most common hereditary colorectal cancer syndrome, and colonoscopy remains the cornerstone of prevention. However, surveillance is limited by missed lesions, variable procedural quality, accelerated neoplastic progression, and the continued occurrence of post-colonoscopy colorectal cancers. This review examines gene-specific differences in colorectal cancer and adenoma risk, quality standards for surveillance colonoscopy, emerging artificial intelligence technologies, and complementary non-endoscopic strategies. Contemporary studies conducted in expert settings have reported higher adenoma detection rates, reflecting improvements in colonoscopy quality. At the same time, randomized trials have shown no clear additional benefit from computer-aided detection when added to high-quality colonoscopy. Among complementary strategies, fecal immunochemical testing may support prioritization and risk stratification, although its optimal threshold, testing interval, and safety for postponing colonoscopy remain uncertain. In parallel, blood-based biomarkers for cancer prediction remain exploratory. Future progress will depend on wider implementation of quality-assured surveillance and prospective validation of adjunctive tools that can safely guide colonoscopy timing and reduce the occurrence of post-colonoscopy colorectal cancers.
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BibTeX
@article{castilloiturra2026colorectal,
title = {{Colorectal cancer surveillance in Lynch syndrome: quality standards, emerging technology and complementary strategies.}},
author = {Joaquín Castillo-Iturra and Evelien Dekker and Francesc Balaguer},
journal = {Familial cancer},
year = {2026},
month = oct,
doi = {10.1007/s10689-026-00608-6},
url = {https://europepmc.org/article/MED/42905176},
note = {CC BY},
}
RIS
TY - JOUR
TI - Colorectal cancer surveillance in Lynch syndrome: quality standards, emerging technology and complementary strategies.
AU - Joaquín Castillo-Iturra
AU - Evelien Dekker
AU - Francesc Balaguer
PY - 2026
DA - 2026/10/21
JO - Familial cancer
DO - 10.1007/s10689-026-00608-6
UR - https://europepmc.org/article/MED/42905176
AB - Lynch syndrome is the most common hereditary colorectal cancer syndrome, and colonoscopy remains the cornerstone of prevention. However, surveillance is limited by missed lesions, variable procedural quality, accelerated neoplastic progression, and the continued occurrence of post-colonoscopy colorectal cancers. This review examines gene-specific differences in colorectal cancer and adenoma risk, quality standards for surveillance colonoscopy, emerging artificial intelligence technologies, and complementary non-endoscopic strategies. Contemporary studies conducted in expert settings have reported higher adenoma detection rates, reflecting improvements in colonoscopy quality. At the same time, randomized trials have shown no clear additional benefit from computer-aided detection when added to high-quality colonoscopy. Among complementary strategies, fecal immunochemical testing may support prioritization and risk stratification, although its optimal threshold, testing interval, and safety for postponing colonoscopy remain uncertain. In parallel, blood-based biomarkers for cancer prediction remain exploratory. Future progress will depend on wider implementation of quality-assured surveillance and prospective validation of adjunctive tools that can safely guide colonoscopy timing and reduce the occurrence of post-colonoscopy colorectal cancers.
SN - 1389-9600
SN - 1573-7292
ER -