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Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome

Background: Lynch syndrome is a hereditary disorder, with a very high risk of the developing colorectal cancer (CRC) and a predilection to develop other cancers, including upper tract urothelial carcinoma (UTUC) that has an estimated lifetime risk of 0.2-25%, above that of the general population. Ou...

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Main Author: Pluke, Kent David
Other Authors: Kaestner, Lisa-Ann
Format: Thesis
Language:English
Published: Division of General Surgery 2022
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access_status_str Open Access
author Pluke, Kent David
author2 Kaestner, Lisa-Ann
author_browse Kaestner, Lisa-Ann
Pluke, Kent David
author_facet Kaestner, Lisa-Ann
Pluke, Kent David
author_sort Pluke, Kent David
collection Thesis
description Background: Lynch syndrome is a hereditary disorder, with a very high risk of the developing colorectal cancer (CRC) and a predilection to develop other cancers, including upper tract urothelial carcinoma (UTUC) that has an estimated lifetime risk of 0.2-25%, above that of the general population. Our aim was to assess the prevalence of UTUC in a Lynch syndrome cohort undergoing screening for CRC, to determine the need for a UTUC screening program. Methodology: Lynch syndrome patients were screened with urine dipstix for microscopic haematuria. Patients with confirmed microhaematuria were offered urine cytology, microscopy and culture, ultrasound (US) of their upper tracts and flexible cystoscopy. Results: Of the 89 patients screened, 86 had an MLH1 mutation and 2 had an MSH2 mutation. Eleven of the 12 patients who had microscopic haematuria were female. 10 patients had urinary tract infections. One patient had follicular cystitis and another had a simple renal cyst. No patients had hydronephrosis on ultrasound. All urine cytology specimens were negative for malignancy. Conclusion: No cases of UTUC were detected in our cohort during this study. A more rational screening protocol in this group may be to screen patients for UTUC with known MSH2 mutations at an earlier age (over 35).
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:32:29.432Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2022
publishDateRange 2022
publishDateSort 2022
publisher Division of General Surgery
publisherStr Division of General Surgery
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/35501 Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome Pluke, Kent David Kaestner, Lisa-Ann upper tract urothelial cell carcinoma integrated screening existing colorectal malignancy screening program Lynch syndrome Background: Lynch syndrome is a hereditary disorder, with a very high risk of the developing colorectal cancer (CRC) and a predilection to develop other cancers, including upper tract urothelial carcinoma (UTUC) that has an estimated lifetime risk of 0.2-25%, above that of the general population. Our aim was to assess the prevalence of UTUC in a Lynch syndrome cohort undergoing screening for CRC, to determine the need for a UTUC screening program. Methodology: Lynch syndrome patients were screened with urine dipstix for microscopic haematuria. Patients with confirmed microhaematuria were offered urine cytology, microscopy and culture, ultrasound (US) of their upper tracts and flexible cystoscopy. Results: Of the 89 patients screened, 86 had an MLH1 mutation and 2 had an MSH2 mutation. Eleven of the 12 patients who had microscopic haematuria were female. 10 patients had urinary tract infections. One patient had follicular cystitis and another had a simple renal cyst. No patients had hydronephrosis on ultrasound. All urine cytology specimens were negative for malignancy. Conclusion: No cases of UTUC were detected in our cohort during this study. A more rational screening protocol in this group may be to screen patients for UTUC with known MSH2 mutations at an earlier age (over 35). 2022-01-18T08:38:03Z 2022-01-18T08:38:03Z 2021 2022-01-18T08:37:33Z Master Thesis Masters MMed http://hdl.handle.net/11427/35501 eng application/pdf Division of General Surgery Faculty of Health Sciences
spellingShingle upper tract urothelial cell carcinoma
integrated screening
existing colorectal malignancy screening program
Lynch syndrome
Pluke, Kent David
Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
thesis_degree_str Master's
title Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
title_full Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
title_fullStr Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
title_full_unstemmed Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
title_short Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
title_sort lessons from a pilot study of screening for upper tract urothelial cell carcinoma in lynch syndrome
topic upper tract urothelial cell carcinoma
integrated screening
existing colorectal malignancy screening program
Lynch syndrome
url http://hdl.handle.net/11427/35501
work_keys_str_mv AT plukekentdavid lessonsfromapilotstudyofscreeningforuppertracturothelialcellcarcinomainlynchsyndrome