Project on optimizing colorectal cancer surveillance in Lynch Syndrome is granted!

Marjolein Greuter 21 December 2022

Last week, the Maag Darm Lever Stichting announced that our project ‘Towards personalized colorectal cancer surveillance in individuals with Lynch syndrome’ led by Dr. Veerle Coupé was granted.

Individuals with Lynch syndrome (LS) have a high risk (25%-70% lifetime risk) of developing colorectal cancer (CRC) due to a genetic mutation. To reduce this risk, they are currently recommended to undergo two-yearly colonoscopy surveillance. However, there is accumulating evidence that CRC risk depends on an individual’s risk profile. This suggests that surveillance can be optimized by switching from the current one-size-fits-all approach to risk-based surveillance strategies. In this project, we aim to optimize CRC surveillance in individuals with LS by evaluating the long-term benefits, harms and cost-effectiveness of risk-based surveillance strategies from a Dutch perspective.

In this project, we will estimate adenoma incidence and progression rates to colorectal cancer in individuals with Lynch syndrome by applying a Bayesian accelerated failure time model to prospectively collected person-level surveillance data. This Bayesian model is developed by Dr. Thomas Klausch and is accepted for publication in the Annals of Applied Statistics. Subsequently, we will adapt the existing ASCCA  model, which currently simulates the natural history of CRC in average-risk individuals, to reflect CRC risk in LS individuals. With the ASCCA-Lynch model, we will evaluate a range of risk-based surveillance strategies in terms of benefits, harms and cost-effectiveness.