Table 3.

Surveillance recommendations for hereditary colorectal cancer syndrome

Syndrome	Organ	Start age (yr)	Interval (yr)	Procedure	GRADEa
LS and LS-spectrumb	Colon	20–25	1–2	Colonoscopy	High
	EM, cervix, ovary	30–35	1–2	Biopsy, USG, PS	Moderate
	Stomach, duodenum	30–35	1–3	EGD	Moderate
	Urinary tract	20–35	1	Urinalysis	Very low
	Pancreas	35–40	1–3	MRI, ERCP	Low
EALS	Colon	20–25	1–2	Colonoscopy	High
	Stomach, duodenum	30–35	1–3	EGD	Moderate
FCCTX	Colon	20–25	1–2	Colonoscopy	Moderate
FAP	Colon	12–14	1–2	Colonoscopy	High
	Stomach, duodenum	25–30	1–3	EGD	Moderate
	Thyroid	15–20	1–2	PE and USG	Low
Attenuated FAP	Colon	18–20	1–3	Colonoscopy	High
	Stomach, duodenum	25–30	1–3	EGD	Moderate
MAP	Colon	18–20	1–2	Colonoscopy	High
	Stomach, duodenum	25–30	1–3	EGD	Moderate
PPAP	Colon	25–30	1–3	Colonoscopy	Moderate
	Stomach, duodenum	25–30	1–3	EGD	Low
	EM, cervix, ovary	25–30	1–2	Biopsy, USG, PS	Low
SPS	Colon	Undetermined	1–3	Colonoscopy	Moderate
PJS	Colon	10, 18c	3	Colonoscopy	High
	Upper GI	10, 18c	3	EGD, enteroscopy	High
	Pancreas	30	1–3	MRI, ERCP	Moderate
	Breast	25	1	PE, MG, USG	Moderate
	EM, cervix, ovary	25	1–2	Biopsy, USG, PS	Low
	Testis	Birth–teenage	1	PE, USG	Low
JPS	Colon	12–15	1–3	Colonoscopy	Moderate
	Stomach, duodenum	12–15	1–3	EGD	Low
PTHS	Colon	15	1–3	Colonoscopy	High
	Stomach, duodenum	15	1–3	EGD	Moderate
	Breast	25–35	1	PE, MG, USG	Moderate
	EM, cervix, ovary	30–35	1–2	Biopsy, USG, PS	Low
	Thyroid	15–20	1	PE and USG	Low
	Kidney (renal cell)	18	1	Urinalysis, USG	Low
	Skin (melanoma)	By 18	1	PE	Low
HMPS	Colon	Undetermined	1–3	Colonoscopy	Low

LS, Lynch syndrome; EM, endometrium; USG, ultrasonography; PS, Pap smear; EGD, esophagoduodenoscopy; MRI, magnetic resonance imaging; ERCP, endoscopic retrograde cholangiopancreatography; EALS, EPCAM-associated LS; FCCTX, familial colorectal cancer type X; FAP, familial adenomatous polyposis; PE, physical examination; MAP, MUTYH-associated polyposis; PPAP, polymerase-proofreading-associated polyposis; SPS, sessile polyposis syndrome; PJS, Peutz-Jeghers syndrome; GI, gastrointestinal; MG, mammography; JPS, juvenile polyposis syndrome; PTHS, PTEN hamartoma syndrome; HMPS, hereditary mixed polyposis syndrome.

^aGRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the strength of recommendations and the quality of evidence.

^bLS-spectrum includes Muir-Torre syndrome, Turcot syndrome, and constitutional mismatch repair deficiency.

^cAt age of 8 years, if present every 3 years; if no polyps, repeat at age of 18 years, then every 3 years or earlier on symptom.