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Practice Guideline
. 2020 Mar;69(3):411-444.
doi: 10.1136/gutjnl-2019-319915. Epub 2019 Nov 28.

Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG)

Kevin J Monahan  1   2 , Nicola Bradshaw  3 , Sunil Dolwani  4 , Bianca Desouza  5 , Malcolm G Dunlop  6 , James E East  7   8 , Mohammad Ilyas  9 , Asha Kaur  10 , Fiona Lalloo  11 , Andrew Latchford  12 , Matthew D Rutter  13   14 , Ian Tomlinson  15   16 , Huw J W Thomas  17   2 , James Hill  11 ; Hereditary CRC guidelines eDelphi consensus group
Collaborators, Affiliations
Practice Guideline

Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG)

Kevin J Monahan et al. Gut. 2020 Mar.

Abstract

Heritable factors account for approximately 35% of colorectal cancer (CRC) risk, and almost 30% of the population in the UK have a family history of CRC. The quantification of an individual's lifetime risk of gastrointestinal cancer may incorporate clinical and molecular data, and depends on accurate phenotypic assessment and genetic diagnosis. In turn this may facilitate targeted risk-reducing interventions, including endoscopic surveillance, preventative surgery and chemoprophylaxis, which provide opportunities for cancer prevention. This guideline is an update from the 2010 British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland (BSG/ACPGBI) guidelines for colorectal screening and surveillance in moderate and high-risk groups; however, this guideline is concerned specifically with people who have increased lifetime risk of CRC due to hereditary factors, including those with Lynch syndrome, polyposis or a family history of CRC. On this occasion we invited the UK Cancer Genetics Group (UKCGG), a subgroup within the British Society of Genetic Medicine (BSGM), as a partner to BSG and ACPGBI in the multidisciplinary guideline development process. We also invited external review through the Delphi process by members of the public as well as the steering committees of the European Hereditary Tumour Group (EHTG) and the European Society of Gastrointestinal Endoscopy (ESGE). A systematic review of 10 189 publications was undertaken to develop 67 evidence and expert opinion-based recommendations for the management of hereditary CRC risk. Ten research recommendations are also prioritised to inform clinical management of people at hereditary CRC risk.

Keywords: colorectal cancer; colorectal surgery; genetic testing; inherited cancers; surveillance.

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Conflict of interest statement

Competing interests: KJM: Medical advisory board of Bowel Cancer UK, Lynch Syndrome UK. JH and FL: FAP trial (now closed) with funding awarded to NHS trust research facility. JE: Advisory board Lumendi, Boston Scientific; Speaker fees Olympus, Falk. MDR: Speaker fees: SwissSCWeb, Pentax; Research Grant: Olympus; Consultancy: Norgine.

Figures

Figure 1
Figure 1
Management of people with a family history of colorectal cancer. BSG, British Society of Gastroenterology; CRC, colorectal cancer; FHCC, family history of colorectal cancer; FDR, first degree relative; MMR, mismatch repair.
Figure 2
Figure 2
Gene-specific management of Lynch syndrome. MMR, mismatch repair.
Figure 3
Figure 3
Management of Lynch-like syndrome. CRC, colorectal cancer; FDRs, first degree relatives; FHCC, family history of colorectal cancer, MMR, mismatch repair.
See this image and copyright information in PMC

Comment in

References

    1. Lichtenstein P, Holm NV, Verkasalo PK, et al. Environmental and heritable factors in the causation of cancer — analyses of cohorts of twins from Sweden, Denmark, and Finland. N Engl J Med 2000;343:78–85. 10.1056/NEJM200007133430201 - DOI - PubMed
    1. Mitchell RJ, Campbell H, Farrington SM, et al. Prevalence of family history of colorectal cancer in the general population. Br J Surg 2005;92:1161–4. 10.1002/bjs.5084 - DOI - PubMed
    1. NICE NICE CG164. Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer | guidance | NICE, 2017. Available: https://www.nice.org.uk/guidance/cg164 [Accessed 27 May 2019]. - PubMed
    1. Taylor A, Brady AF, Frayling IM, et al. Consensus for genes to be included on cancer panel tests offered by UK genetics services: guidelines of the UK cancer genetics group. J Med Genet 2018;372:jmedgenet-2017-105188 10.1136/jmedgenet-2017-105188 - DOI - PMC - PubMed
    1. Brouwers MC. Agree next steps Consortium membership. Available: www.agreetrust.org

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