Background: Hereditary colorectal cancer syndromes require timely endoscopic surveillance. Methods: This study evaluated the approach of Italian gastroenterologists to the management of such patients. It then assessed the impact of SARS-CoV-2. All members affiliated with the leading Italian gastroenterology societies (AIGO, SIED, and SIGE) received an online questionnaire. Results: One hundred and twenty-one clinicians from 96 centers answered, not necessarily experts in the field (mean age 50.26 ± 11.22 years). Many collected family history for genetic risk assessment (74.4%), but only 14.0% used an online predictive software. 65.6% discussed cases in multidisciplinary units. Genetic analysis was available to most centers, but only a few hospitals offered dedicated endoscopy (19.0%), outpatient clinics (33.9%), or surgeries (23.1%). Since the start of the SARS-CoV-2 pandemic, the number of clinicians with a high volume of patients decreased (from 38.8% to 28.1%). Almost half of the responders (45.5%) reported a delay in the surveillance (median: 4–12 months). Ultimately, 30.6% detected one interval colorectal cancer in at least one of their patients. Conclusion: The SARS-CoV-2 pandemic directly affected the surveillance of hereditary colorectal cancer syndromes in Italy. Endoscopic surveillance should resume in all centers to avoid the possible long-term consequences of its interruption, especially for inherited colorectal cancer syndromes.

1.
Valle
L
,
Vilar
E
,
Tavtigian
SV
,
Stoffel
EM
.
Genetic predisposition to colorectal cancer: syndromes, genes, classification of genetic variants and implications for precision medicine
.
J Pathol
.
2019
;
247
:
574
.
2.
Yurgelun
MB
,
Kulke
MH
,
Fuchs
CS
,
Allen
BA
,
Uno
H
,
Hornick
JL
,
.
Cancer susceptibility gene mutations in individuals with colorectal cancer
.
J Clin Oncol
.
2017
;
35
:
1086
95
.
3.
Uson
PLS
,
Riegert-Johnson
D
,
Boardman
L
,
Kisiel
J
,
Mountjoy
L
,
Patel
N
,
.
Germline cancer susceptibility gene testing in unselected patients with colorectal adenocarcinoma: a multicenter prospective study
.
Clin Gastroenterol Hepatol
.
2022 Mar
;
20
(
3
):
e508
28
.
4.
Valle
L
,
Gruber
SB
,
Capellá
G
.
Hereditary colorectal cancer: genetic basis and clinical implications
.
Hered Color Cancer Genet Basis Clin Implic
.
2018
:
1
505
.
5.
Mannucci
A
,
Zuppardo
RA
,
Crippa
S
,
Carrera
P
,
Patricelli
MG
,
Russo Raucci
A
,
.
MSH6 gene pathogenic variant identified in familial pancreatic cancer in the absence of colon cancer
.
Eur J Gastroenterol Hepatol
.
2020
;
32
:
345
9
.
6.
Dominguez-Valentin
M
,
Crosbie
EJ
,
Engel
C
,
Aretz
S
,
MacRae
F
,
Winship
I
,
.
Risk-reducing hysterectomy and bilateral salpingo-oophorectomy in female heterozygotes of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report
.
Genet Med
.
2021
;
23
:
705
12
.
7.
Seppälä
TT
,
Dominguez-Valentin
M
,
Crosbie
EJ
,
Engel
C
,
Aretz
S
,
Macrae
F
,
.
Uptake of hysterectomy and bilateral salpingo-oophorectomy in carriers of pathogenic mismatch repair variants: a Prospective Lynch Syndrome Database report
.
Eur J Cancer
.
2021
;
148
:
124
33
.
8.
Dominguez-Valentin
M
,
Seppälä
T
,
Engel
C
,
Aretz
S
,
MacRae
F
,
Winship
I
,
.
Risk-reducing gynecological surgery in Lynch Syndrome: results of an international survey from the Prospective Lynch Syndrome Database
.
J Clin Med
.
2020
;
9
:
2290
.
9.
Monahan
KJ
,
Bradshaw
N
,
Dolwani
S
,
Desouza
B
,
Dunlop
MG
,
East
JE
,
.
Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG)
.
Gut
.
2020
;
69
:
411
.
10.
Syngal
S
,
Brand
RE
,
Church
JM
,
Giardiello
FM
,
Hampel
HL
,
Burt
RW
.
ACG clinical guideline: genetic testing and management of hereditary gastrointestinal cancer syndromes
.
Am J Gastroenterol
.
2015
;
110
:
223
63
.
11.
Seppälä
TT
,
Latchford
A
,
Negoi
I
,
Sampaio Soares
A
,
Jimenez-Rodriguez
R
,
Sánchez-Guillén
L
,
.
European guidelines from the EHTG and ESCP for Lynch syndrome: an updated third edition of the Mallorca guidelines based on gene and gender
.
Br J Surg
.
2021 May 27
;
108
(
5
):
484
98
.
12.
Wagner
A
,
Aretz
S
,
Auranen
A
,
Bruno
MJ
,
Cavestro
GM
,
Crosbie
E
,
.
The management of Peutz-Jeghers Syndrome: European Hereditary Tumour Group (EHTG) guideline
.
J Clin Med
.
2021
;
10
:
473
.
13.
Scaldaferri
F
,
Pugliese
D
,
Privitera
G
,
Onali
S
,
Lopetuso
LR
,
Rizzatti
G
,
.
Impact of COVID-19 pandemic on the daily management of biotechnological therapy in inflammatory bowel disease patients: reorganisational response in a high-volume Italian inflammatory bowel disease centre
.
United European Gastroenterol J
.
2020
;
8
:
775
81
.
14.
Magro
F
,
Abreu
C
,
Rahier
JF
.
The daily impact of COVID-19 in gastroenterology
.
United European Gastroenterol J
.
2020
;
8
:
520
7
.
15.
Chai
N
,
Mei
Z
,
Zhang
W
,
Du
C
,
Wang
X
,
Li
L
,
.
Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy
.
United European Gastroenterol J
.
2020
;
8
:
798
803
.
16.
Hunt
RH
,
East
JE
,
Lanas
A
,
Malfertheiner
P
,
Satsangi
J
,
Scarpignato
C
,
.
COVID-19 and gastrointestinal disease: implications for the gastroenterologist
.
Dig Dis
.
2021
;
39
:
119
39
.
17.
Francisco
CP
,
Cua
IH
,
Aguila
EJ
,
Cabral-Prodigalidad
PA
,
Sy-Janairo
ML
,
Dumagpi
JE
,
.
Moving forward: gradual return of gastroenterology practice during the COVID-19 pandemic
.
Dig Dis
.
2021
;
39
:
140
9
.
18.
Maida
M
,
Sferrazza
S
,
Savarino
E
,
Ricciardiello
L
,
Repici
A
,
Morisco
F
,
.
Impact of the COVID-19 pandemic on Gastroenterology Divisions in Italy: a national survey
.
Dig Liver Dis
.
2020
;
52
:
808
15
.
19.
Kastrinos
F
,
Uno
H
,
Ukaegbu
C
,
Alvero
C
,
McFarland
A
,
Yurgelun
MB
,
.
Development & validation of the PREMM5 model for comprehensive risk assessment of lynch syndrome
.
J Clin Oncol
.
2017
;
35
:
2165
72
.
20.
Lindberg
LJ
,
Rasmussen
M
,
Andersen
KK
,
Nilbert
M
,
Therkildsen
C
.
Benefit from extended surveillance interval on colorectal cancer risk in Lynch syndrome
.
Colorectal Dis
.
2020
;
22
:
529
36
.
21.
Newton
K
,
Green
K
,
Lalloo
F
,
Evans
DG
,
Hill
J
.
Colonoscopy screening compliance and outcomes in patients with lynch syndrome
.
Colorectal Dis
.
2015
;
17
:
38
46
.
22.
Argillander
TE
,
Koornstra
JJ
,
van Kouwen
M
,
Langers
AM
,
Nagengast
FM
,
Vecht
J
,
.
Features of incident colorectal cancer in Lynch syndrome
.
United European Gastroenterol J
.
2018
;
6
:
1215
22
.
23.
Engel
C
,
Rahner
N
,
Schulmann
K
,
Holinski-Feder
E
,
Goecke
T
,
Schackert
HK
,
.
Efficacy of annual colonoscopic surveillance in individuals with hereditary nonpolyposis colorectal cancer
.
Clin Gastroenterol Hepatol
.
2010
;
8
:
174
82
.
24.
Perin
DMP
,
Elfström
KM
,
Bulliard
J-L
,
Burón
A
,
Campbell
C
,
Flugelman
AA
,
.
Early assessment of the first wave of the COVID-19 pandemic on cancer screening services: The International Cancer Screening Network COVID-19 survey
.
Prev Med
.
2021
;
151
:
106642
.
25.
Mannucci
A
,
Sloane Furniss
C
,
Ukaegbu
CI
,
Horiguchi
M
,
Fehlmann
T
,
Uno
H
,
.
Comparison of colorectal and endometrial microsatellite instability tumor analysis and premm 5 risk assessment for predicting pathogenic germline variants on multigene panel testing
.
J Clin Oncol
.
2020
;
38
:
4086
94
.
26.
Borras
J
,
Albreht
T
,
Audisio
R
,
Briers
E
,
Casali
P
,
Esperou
H
,
.
Policy statement on multidisciplinary cancer care
.
Eur J Cancer
.
2014
;
50
:
475
80
.
27.
Pullen
LC
.
Evidence supports the use of multidisciplinary team meetings
.
CA Cancer J Clin
.
2017
;
67
:
351
2
.
28.
Basta
YL
,
Baur
OL
,
van Dieren
S
,
Klinkenbijl
JHG
,
Fockens
P
,
Tytgat
KMAJ
.
Is there a benefit of multidisciplinary cancer team meetings for patients with gastrointestinal malignancies
.
Ann Surg Oncol
.
2016
;
23
:
2430
.
29.
Kanth
P
,
Grimmett
J
,
Champine
M
,
Burt
R
,
Samadder
NJ
.
Hereditary colorectal polyposis and cancer syndromes: a primer on diagnosis and management
.
Am J Gastroenterol
.
2017
;
112
:
1509
25
. http://dx.doi.org/10.1038/ajg.2017.212.
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