% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Engel:141669,
      author       = {C. Engel and H. F. Vasen and T. Seppälä and S. Aretz and
                      M. Bigirwamungu-Bargeman and S. Y. de Boer and K. Bucksch
                      and R. Büttner and E. Holinski-Feder and S. Holzapfel and
                      R. Hüneburg and M. A. J. M. Jacobs and H. Järvinen and M.
                      Kloor$^*$ and M. von Knebel Doeberitz$^*$ and J. J.
                      Koornstra and M. van Kouwen and A. M. Langers and P. C. van
                      de Meeberg and M. Morak and G. Möslein and F. M. Nagengast
                      and K. Pylvänäinen and N. Rahner and L. Renkonen-Sinisalo
                      and S. Sanduleanu and H. K. Schackert and W. Schmiegel and
                      K. Schulmann and V. Steinke-Lange and C. P. Strassburg and
                      J. Vecht and M.-L. Verhulst and W. de Vos Tot Nederveen
                      Cappel and S. Zachariae and J.-P. Mecklin and M. Loeffler},
      collaboration = {t. D. L. S. C. G. German HNPCC Consortium},
      title        = {{N}o {D}ifference in {C}olorectal {C}ancer {I}ncidence or
                      {S}tage at {D}etection by {C}olonoscopy {A}mong 3
                      {C}ountries {W}ith {D}ifferent {L}ynch {S}yndrome
                      {S}urveillance {P}olicies.},
      journal      = {Gastroenterology},
      volume       = {155},
      number       = {5},
      issn         = {0016-5085},
      address      = {Philadelphia, Pa. [u.a.]},
      publisher    = {Saunders},
      reportid     = {DKFZ-2018-01940},
      pages        = {1400 - 1409.e2},
      year         = {2018},
      abstract     = {Patients with Lynch syndrome are at high risk for
                      developing colorectal cancer (CRC). Regular colonoscopic
                      surveillance is recommended, but there is no international
                      consensus on the appropriate interval. We investigated
                      whether shorter intervals are associated with lower CRC
                      incidence and detection at earlier stages by comparing the
                      surveillance policies in Germany, which evaluates patients
                      by colonoscopy annually, in the Netherlands (patients
                      evaluated at 1-2-year intervals), and Finland (patients
                      evaluated at 2-3-year intervals).We collected data from
                      16,327 colonoscopic examinations (conducted from 1984
                      through 2015) of 2747 patients with Lynch syndrome
                      (pathogenic variants in the MLH1, MSH2, or MSH6 genes) from
                      the German HNPCC Consortium, the Dutch Lynch Syndrome
                      Registry, and the Finnish Lynch Syndrome Registry. Our
                      analysis included 23,309 person-years of cumulative
                      observation time. Time from the index colonoscopy to
                      incident CRC or adenoma was analyzed using the Kaplan-Meier
                      method; groups were compared using the log-rank test. We
                      performed multivariable Cox regression analyses to identify
                      factors associated with CRC risk (diagnosis of CRC before
                      the index colonoscopy, sex, mutation, age, and presence of
                      adenoma at the index colonoscopy).The 10-year cumulative CRC
                      incidence ranged from $4.1\%$ to $18.4\%$ in patients with
                      low- and high-risk profiles, respectively, and varied with
                      age, sex, mutation, and prior detection of CRC or adenoma.
                      Observed colonoscopy intervals were largely in accordance
                      with the country-specific recommendations. We found no
                      significant differences in cumulative CRC incidence or CRC
                      stage at detection among countries. There was no significant
                      association between CRC stage and time since last
                      colonoscopy.We did not find a significant reduction in CRC
                      incidence or stage of detection in Germany (annual
                      colonoscopic surveillance) than in countries with longer
                      surveillance intervals (the Netherlands, with 1-2-year
                      intervals, and Finland, with 2-3-year intervals). Overall,
                      we did not find a significant association of the interval
                      with CRC risk, although age, sex, mutation, and prior
                      neoplasia were used to individually modify colonoscopy
                      intervals. Studies are needed to develop and validate
                      risk-adapted surveillance strategies and to identify
                      patients who benefit from shorter surveillance intervals.},
      cin          = {G105},
      ddc          = {610},
      cid          = {I:(DE-He78)G105-20160331},
      pnm          = {317 - Translational cancer research (POF3-317)},
      pid          = {G:(DE-HGF)POF3-317},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30063918},
      doi          = {10.1053/j.gastro.2018.07.030},
      url          = {https://inrepo02.dkfz.de/record/141669},
}