Screening for upper urinary tract urothelial cell carcinoma development in Lynch syndrome: a retrospective, cross-sectional, observational study.

Kikkert, R. (Robert) (2017) Screening for upper urinary tract urothelial cell carcinoma development in Lynch syndrome: a retrospective, cross-sectional, observational study. thesis, Medicine.

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Abstract

Aim The aim of this study was to measure the behavior and awareness level of urologists and gastroenterologists regarding screening and surveillance of UUT-UUC in Lynch syndrome patients. Method We designed a retrospective, cross-sectional, observational study with an ambiguous construction. In the Netherlands Foundation for the Detection of Hereditary Tumors, we included 111 LS-patients from 4 gastroenterologists who treat and control most LS-patients in the Netherlands. Of this group, we registered which genetic mutations were present and which patients were screened using urinalysis, urine cytology and kidney ultrasound. Secondly, we created questionnaires for Dutch urologists, urology residents and gastroenterologists. Question items were focused on screening and referral behavior, awareness level of UUT-UCC as a manifestation of LS-patients and treatment of bladder tumors associated with Lynch syndrome. Results 111 patients had a total of 491 screening methods performed, which led to 1 UUT-UCC discovery and two bladder tumors, all within the MSH2 mutation carrier group. Of the questionnaires, 84.6% of the urologists and urology residents were aware of UUT-UCC as a manifestation of Lynch Syndrome. 52.3% of the urologists never ask patients with bladder cancer for family members with Lynch syndrome. 41.7% of the gastroenterologists do not screen for UUT-UCC in LS-patients, with very different practices amongst the gastroenterologists who do screen. Conclusion a large variety exists regarding UUT-UCC screening and surveillance behavior of urologists and gastroenterologists. Future prospective cohort studies or RCT’s are necessary to make a definite statement regarding screening for UUT-UCC in LS-patients. Urinalysis, urine cytology and kidney ultrasound are not useful screening methods outside a research project. Our data indicate a screening strategy that would focus more on MSH2 mutation carriers.

Item Type:	Thesis (Thesis)
Supervisor name:	Facultair begeleider: and Doornweerd, drs. B.H.J and Afdeling: Urologie, Universitair Medisch Centrum Groningen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:42
Last Modified:	25 Jun 2020 10:42
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/337

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