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Hépato-Gastro & Oncologie Digestive

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Management of digestive polyposis and predisposition syndromes for colorectal cancer. What is new in 2021? Volume 28, issue 9, November 2021

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Authors
1 Hôpital Cochin, Service d’hépato-gastroentérologie et endoscopie digestive, 27 rue du Faubourg Saint-Jacques, 75014 Paris
2 Hôpital Européen Georges Pompidou, Service d’hépato-gastroentérologie et endoscopie digestive, 20 rue Leblanc, 75015 Paris
3 Réseau de prise en charge des patients prédisposés aux cancers digestifs d’Ile-de-France. PRED-IdF
* Correspondance

Most of colorectal cancers (CRC) develop in a sporadic context. However, it is estimated that around 35% of CRCs have a familial component and that 2 to 5% occur as part of a genetic predisposition. Among this population, we can distinguish between two phenoptypes: The so-called “polyposis” syndromes and those called “non-polyposis” syndromes, mainly represented by the Lynch syndrome. The particularity of these syndromes is that they present a broad carcinological spectrum, affecting both the colon but also other digestive or extra digestive organs (endometrium, ovary, etc.). The identification and management of these syndromes requires a multidisciplinary approach, the cornerstone of which is based on consultation of oncogenetics accessible via one of the 17 regional or inter-regional networks of the oncogenetics system (INCa 2012). These networks make it possible to organize and coordinate manadgment, by developing specific personalized follow-up plans (PPS). Digestive endoscopy plays a central role in this, ensuring both a cancer screening and prevention role. In this update, we will discuss the latest management recommendations, syndrome by syndrome.