- Author
-
V.H. Roos
- Title
- Optimizing detection and management of familial and hereditary colorectal cancer syndromes
- Supervisors
-
E. Dekker
P.M.M. Bossuyt - Co-supervisors
-
C.M. Aalfs
- Award date
- 18 June 2021
- Number of pages
- 241
- ISBN
- 9789493197626
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
Early recognition of familial and hereditary colorectal cancer (CRC) syndromes is at the core of screening and surveillance strategies for patients and their family members, aiming to prevent morbidity and mortality from CRC. Endoscopy facilitates detection and resection of precursor lesions of CRC: adenomas and serrated polyps. Despite the known benefits of colonoscopy surveillance in patients with familial and hereditary CRC syndromes about 70% to 85% are still unidentified.
In the first part of this thesis we focused on improving the detection of patients with familial and hereditary CRC syndromes. We observed that addition of an online validated family history questionnaire to the existing Dutch fecal immunochemical testing (FIT) based CRC screening program did not improve the diagnostic yield compared to the FIT only strategy. Furthermore only a few individuals with familial and hereditary CRC syndromes were identified. We also explored invitees’ consideration on participating in this new approach and observed that participation was not always based on full knowledge of the possible consequences. The second part of this thesis focused on the relative and absolute CRC risk estimations in patients with a familial CRC risk. In the third part we demonstrated the safety and effectiveness of endoscopic resections of gastric and duodenal adenomas, investigated the adenoma distribution post-colectomy and the potential of Sirolimus as a chemopreventive agent in patients with Familial Adenomatous Polyposis. In the final part we confirmed the importance of key colonoscopy quality indicators to ensure adenoma detection and prevent post-colonoscopy CRC in patients with Lynch syndrome. - Persistent Identifier
- https://hdl.handle.net/11245.1/6f321741-7fea-4b86-a8fd-345447af667a
- Downloads
-
Thesis (complete)
Front matter
Chapter 1: General Introduction and outline of this thesis
Chapter 2: Addition of an online, validated family history questionnaire to the Dutch FIT-based screening programme did not improve its diagnostic yield
Chapter 3: Familial risk assessment in a colorectal cancer screening program: A qualitative study on invitees’ considerations
Chapter 4: Effects of family history on relative and absolute colorectal cancer risk: A systematic review and meta-analysis
Chapter 5: Gastric adenomas and their management in familial adenomatous polyposis
Chapter 6: Gastric adenomas in familial adenomatous polyposis: You only see them when you know what to look for
Chapter 7: Endoscopic management of duodenal adenomas in patients with familial adenomatous polyposis
Chapter 8: Restoration of intestinal continuity in patients with familial adenomatous polyposis is associated with adenoma development after proctocolectomy: The effect of fecal stasis?
Chapter 9: Sirolimus for the treatment of polyposis of the rectal remnant and ileal pouch in four patients with familial adenomatous polyposis: A pilot study
Chapter 10: Quality of colonoscopy is associated with adenoma detection and post-colonoscopy colorectal cancer prevention in Lynch syndrome
Chapter 11: Thesis summary and future perspectives
Summary in Dutch (Nederlandse samenvatting)
Contributing authors; List of publications; PhD portfolio; Acknowledgements (Dankwoord); About the author
- Supplementary materials
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