Surveillance protocol for patients with CMMR-D proposed by the European consortium
| Type of cancer | Lower age limit | Procedure/interval |
|---|---|---|
| Brain tumours | From age 2 years | MRI, 1×/6–12 months |
| Digestive tract cancer | ||
| SBC | From age 10 years | VCE, upper gastrointestinal endoscopy*; 1×/year |
| CRC | From age 8 years | Ileocolonoscopy; 1×/year; |
| Haematological malignancies | ||
| NHL/other lymphoma | From age 1 year | Clinical examination 1×/6 months Optional: abdominal ultrasound 1×/6 months |
| Leukaemia | From age 1 year | Blood count 1×/6smonths |
| LS-associated cancers† | From age 20 years | Gynaecological examination, transvaginal US, Pipelle curettage (1×/year), |
| Urine cytology, dipstick (1×/year) | ||
| All cancers | Parents and patients should be advised to contact their doctor in case of unusual signs or symptoms. A pamphlet should be available with information about the signs/symptoms that may occur. | |
*At the same time as colonoscopy under general anaesthesia.
†See: Revised guidelines for the clinical management of Lynch syndrome: HFA Vasen et al Gut 2013.
CMMR-D, constitutional mismatch repair-deficiency; CRC, colorectal cancer; LS, Lynch syndrome; SBC, small bowel cancer; NHL, non-Hodgkin lymphoma; VCE, video capsule endoscopy.