Columbia University Health Sciences
United States
Optimal Colorectal Cancer Surveillance Strategy for Lynch Syndrome by Genotype
Optimizing Screening of Early-Onset Colorectal Cancer Background: Colorectal cancer (CRC) constitutes a significant source of morbidity and mortality, with screening playing a pivotal role in alleviating this burden. The routine incorporation of screening colonoscopy for individuals aged 50 or older, who are at average risk, has contributed to a notable reduction in CRC incidence and mortality, by 35% and 37% respectively. Nevertheless, a substantial proportion of eligible individuals do not undergo screening, contributing to 28-44% of CRC-related deaths. In the United States, disparities are evident among Black individuals, who are more prone to being diagnosed at younger ages and in advanced disease stages. Timely detection of CRC can significantly enhance survival by enabling curative colonoscopy procedures. Innovative, targeted strategies for CRC prevention hold promise for improving overall population health and mitigating CRC disparities in the U.S. Goal: The overarching objective is to enhance the effectiveness of cancer surveillance for individuals at risk of early-onset colorectal cancer by tailoring the surveillance approach to each person's estimated risk of CRC incidence and mortality. This goal aims to improve the overall well-being of patients, optimize resource allocation, and foster greater acceptance of surveillance among both patients and healthcare providers.
Publications
- Rustgi SD, Kastrinos F. Screening for Lynch Syndrome: Optimal Strategies and Performance Remain a Moving Target. The American journal of gastroenterology. 2023 Feb 1;118(2):259-260. Epub 2022 Sep 21. PMID: 36735557
- Park J, Karnati H, Rustgi SD, Hur C, Kong XF, Kastrinos F. Impact of population screening for Lynch syndrome insights from the All of Us data. Nature communications. 2025 Jan 9;16(1):523. PMID: 39788943
- Kastrinos F, Kupfer SS, Gupta S. Colorectal Cancer Risk Assessment and Precision Approaches to Screening: Brave New World or Worlds Apart? Gastroenterology. 2023 Apr;164(5):812-827. Epub 2023 Feb 24. PMID: 36841490
- Artin MG, Soddano J, Rustgi SD, Aziz Z, Lim F, Yang JY, Ingram MA, Nathanson JT, Kao JY, Hur C. Initial Diagnostic Strategies for Helicobacter Pylori in Patients With Bleeding Peptic Ulcers Undergoing Endoscopy: A Cost-Effectiveness Analysis. Gastro hep advances. 2024 Dec 15;4(4):100602. doi: 10.1016/j.gastha.2024.100602. eCollection 2025. PMID: 39996244
- Kastrinos F, Ingram MA, Silver ER, Oh A, Laszkowska M, Rustgi AK, Hur C. Gene-Specific Variation in Colorectal Cancer Surveillance Strategies for Lynch Syndrome. Gastroenterology. 2021 Aug;161(2):453-462.e15. Epub 2021 Apr 9. PMID: 33839100
- Aziz Z, Wagner S, Agyekum A, Pumpalova YS, Prest M, Lim F, Rustgi S, Kastrinos F, Grady WM, Hur C. Cost-Effectiveness of Liquid Biopsy for Colorectal Cancer Screening in Patients Who Are Unscreened. JAMA network open. 2023 Nov 1;6(11):e2343392. PMID: 37971743