Multiple colorectal adenomas in Lynch syndrome

Ayushi Jain; Maryam Alimirah; Heather Hampel; Rachel Pearlman; Jianing Ma; Jing Peng; Matthew F Kalady; Peter P Stanich

doi:10.3389/fonc.2022.1038678

Multiple colorectal adenomas in Lynch syndrome

Front Oncol. 2022 Dec 20:12:1038678. doi: 10.3389/fonc.2022.1038678. eCollection 2022.

Authors

Ayushi Jain¹, Maryam Alimirah², Heather Hampel³, Rachel Pearlman⁴, Jianing Ma⁵, Jing Peng⁵, Matthew F Kalady^{4

6}, Peter P Stanich²

Affiliations

¹ Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
² Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
³ Division of Clinical Cancer Genomics, City of Hope National Medical Center, Duarte, CA, United States.
⁴ Division of Human Genetics, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
⁵ Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, OH, United States.
⁶ Division of Colorectal Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, United States.

Abstract

Background: Lynch syndrome has not traditionally been considered to have a high colorectal adenoma burden. However, with increasing adenoma detection rates in the general population, the incidence of adenoma detection in Lynch syndrome may also be increasing and leading to higher cumulative adenoma counts.

Aim: To clarify the prevalence and clinical impact of multiple colorectal adenomas (MCRA) in Lynch syndrome.

Methods: A retrospective review of patients with Lynch syndrome at our institution was performed to assess for MCRA (defined as ≥10 cumulative adenomas).

Results: There were 222 patients with Lynch syndrome among whom 14 (6.3%) met MCRA criteria. These patients had increased incidence of advanced neoplasia (OR 10, 95% CI: 2.7-66.7).

Conclusions: MCRA is not unusual in Lynch syndrome and is associated with a significantly increased likelihood of advanced colon neoplasia. Consideration should be given to differentiating colonoscopy intervals based on the presence of polyposis in Lynch syndrome.

Keywords: Lynch; adenomas; colon cancer; lynch syndrome; multiple adenomas.