Personalized endoscopic surveillance and intervention protocols for patients with familial adenomatous polyposis: the European FAP Consortium strategy
Endoscopy International Open, vol. 11, pp. E386–E393
Abstract
Abstract Background and study aims Patients with familial adenomatous polyposis (FAP) undergo colectomy and lifelong endoscopic surveillance to prevent colorectal, duodenal and gastric cancer. Endoscopy has advanced significantly in recent years, including both detection technology as well as treatment options. For the lower gastrointestinal tract, current guidelines do not provide clear recommendations for surveillance intervals. Furthermore, the Spigelman staging system for duodenal polyposis has its limitations. We present a newly developed personalized endoscopic surveillance strategy for the lower and upper gastrointestinal tract, aiming to improve the care for patients with FAP. We aim to inform centers caring for FAP patients and encourage the discussion on optimizing endoscopic surveillance and treatment in this high-risk population. Methods The European FAP Consortium, consisting of endoscopists with expertise in FAP, collaboratively developed new surveillance protocols. The proposed strategy was consensus-based and a result of several consortium meetings, discussing current evidence and limitations of existing systems. This strategy provides clear indications for endoscopic polypectomy in the rectum, pouch, duodenum and stomach and defines new criteria for surveillance intervals. This strategy will be evaluated in a 5-year prospective study in nine FAP expert centers in Europe. Results We present a newly developed personalized endoscopic surveillance and endoscopic treatment strategy for patients with FAP aiming to prevent cancer, optimize endoscopic resources and limit the number of surgical interventions. Following this new strategy, prospectively collected data in a large cohort of patients will inform us on the efficacy and safety of the proposed approaches.
Authors 14
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Amsterdam UMC Location University of Amsterdam · Cancer Center Amsterdam · Amsterdam Gastroenterology Endocrinology Metabolism
Affiliation as printed
Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
Cancer Center Amsterdam, Amsterdam, the Netherlands
Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
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Hospital Clínic de Barcelona · Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · Consorci Institut D'Investigacions Biomediques August Pi I Sunyer · Universitat de Barcelona
Affiliation as printed
Department of Gastroenterology, Hospital Clínic de Barcelona, Institut dʼInvestigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
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Amsterdam UMC Location University of Amsterdam · Cancer Center Amsterdam · Amsterdam Gastroenterology Endocrinology Metabolism
Affiliation as printed
Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
Cancer Center Amsterdam, Amsterdam, the Netherlands
Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
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Leiden University Medical Center · The Netherlands Cancer Institute
Affiliation as printed
Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
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Hospital General Universitario de Alicante Doctor Balmis · Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL)
Affiliation as printed
Servicio de Medicina Digestiva, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica ISABIAL, Universidad Miguel Hernández, Alicante, Spain
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Hospital Clínic de Barcelona · Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · Consorci Institut D'Investigacions Biomediques August Pi I Sunyer · Universitat de Barcelona
Affiliation as printed
Department of Gastroenterology, Hospital Clínic de Barcelona, Institut dʼInvestigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
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The Maria Sklodowska-Curie National Research Institute of Oncology
Affiliation as printed
Department of Oncological Gastroenterology and Department of Cancer Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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University of Copenhagen · Amager Hospital · Hvidovre Hospital · Copenhagen University Hospital
Affiliation as printed
Danish Polyposis Registry. Gastrounit, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
Danish Polyposis Registry, Gastrounit, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
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Hospices Civils de Lyon · Hôpital Edouard Herriot
Affiliation as printed
Gastroenterology Unit, Hospices Civils de Lyon, Hôpital E. Herriot, Lyon, France
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Amsterdam UMC Location University of Amsterdam · Cancer Center Amsterdam
Affiliation as printed
Amsterdam UMC location University of Amsterdam, Department of Surgery, Amsterdam, the Netherlands
Cancer Center Amsterdam, Amsterdam, the Netherlands
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
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Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Amsterdam UMC location University of Amsterdam, Department of Epidemiology and Data Science, Amsterdam, the Netherlands
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IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola · University of Bologna
Affiliation as printed
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di SantʼOrsola, Bologna, Italy
Policlinico di Sant'Orsola, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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St Mark's Hospital · Imperial College London
Affiliation as printed
Department of Surgery and Cancer, Imperial College, London, United Kingdom
Polyposis Registry, St Markʼs Hospital, Harrow, United Kingdom
Department of Surgery and Cancer, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland
Polyposis Registry, St Mark's Hospital, Harrow, United Kingdom of Great Britain and Northern Ireland
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Evelien Dekker corresponding
Amsterdam UMC Location University of Amsterdam · Cancer Center Amsterdam · Amsterdam Gastroenterology Endocrinology Metabolism
Affiliation as printed
Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, the Netherlands
Amsterdam UMC location University of Amsterdam, Department of Gastroenterology and Hepatology, Amsterdam, the Netherlands
Cancer Center Amsterdam, Amsterdam, the Netherlands
Department of Gastroenterology and Hepatology, Cancer Center Amsterdam, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
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