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

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dc.contributor.advisorKaestner, Lisa-Ann
dc.contributor.authorPluke, Kent David
dc.date.accessioned2022-01-18T08:38:03Z
dc.date.available2022-01-18T08:38:03Z
dc.date.issued2021
dc.date.updated2022-01-18T08:37:33Z
dc.description.abstractBackground: 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).
dc.identifier.apacitationPluke, K. D. (2021). <i>Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome</i>. (). ,Faculty of Health Sciences ,Division of General Surgery. Retrieved from http://hdl.handle.net/11427/35501en_ZA
dc.identifier.chicagocitationPluke, Kent David. <i>"Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome."</i> ., ,Faculty of Health Sciences ,Division of General Surgery, 2021. http://hdl.handle.net/11427/35501en_ZA
dc.identifier.citationPluke, K.D. 2021. Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome. . ,Faculty of Health Sciences ,Division of General Surgery. http://hdl.handle.net/11427/35501en_ZA
dc.identifier.ris TY - Master Thesis AU - Pluke, Kent David AB - 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). DA - 2021 DB - OpenUCT DP - University of Cape Town KW - upper tract urothelial cell carcinoma KW - integrated screening KW - existing colorectal malignancy screening program KW - Lynch syndrome LK - https://open.uct.ac.za PY - 2021 T1 - Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome TI - Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome UR - http://hdl.handle.net/11427/35501 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35501
dc.identifier.vancouvercitationPluke KD. Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome. []. ,Faculty of Health Sciences ,Division of General Surgery, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35501en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDivision of General Surgery
dc.publisher.facultyFaculty of Health Sciences
dc.subjectupper tract urothelial cell carcinoma
dc.subjectintegrated screening
dc.subjectexisting colorectal malignancy screening program
dc.subjectLynch syndrome
dc.titleLessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch Syndrome
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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