Table 3.

Studies evaluating surveillance of UGI cancer in Lynch syndrome.

Author Year Country	Study Design	Pre-Cancerous Lesion Detection	Cancers and Staging Detection	Conclusions
Kumar [32] 2020 United States	Retrospective, Registry Indication for EGD: symptoms or surveillance N = 217	◦BE: 3.2% ◦GIM: 8.3% ◦H pylori: 2.8% ◦Duodenal adenomas: 1.8%	◦UGI cancer: 5% (11/217) ◦1 esophageal squamous cell, 6 gastric adenocarcinomas, 4 duodenal adenocarcinomas ◦5/11 cancers detected on surveillance, 80% stage I ◦6/11 detected on diagnostic EGD, 33% stage I	◦ EGD surveillance associated with: ◦ Early-stage cancer detection
Farha [31] 2021 United States	Retrospective, Registry Indication for EGD: asymptomatic surveillance N = 323	◦BE: 6.5% ◦H pylori: 3.8% ◦GIM: 5.7% ◦Gastric adenomas: 0.6% ◦Gastric hyperplastic polyps > 5mm: 1.9% ◦Duodenal adenomas: 1.5%	◦UGI cancer: 1.5% (5/323) ◦1 esophageal adenocarcinoma, 1 gastric adenocarcinoma, 1 gastric NET, 2 duodenal adenocarcinomas ◦4/5 (80%) detected at stage I and 1 patient at stage IIB	◦ EGD surveillance associated with: ◦ Early-stage cancer detection ◦ Clinically actionable findings on both baseline and surveillance EGD
Ceravolo [45] 2021 United States	Retrospective Indication for EGD: asymptomatic surveillance N = 247	◦H pylori: 6.9% ◦GIM: 10.1% ◦Gastric adenoma: 0.8% ◦Duodenal adenoma: 2.8% ◦Ampullary adenoma: 0.8%	◦Gastric cancer: 0.8% (2/247); one stage pT1a and one stage pT3 ◦Duodenal cancer: 0.8% (2/247), one stage pT2 and one stage T1	◦ EGD surveillance is useful to: ◦ Detect precancerous and cancerous UGI lesions
Vangala [65] 2021 Germany	Retrospective, Registry Indication for EGD: symptoms or surveillance N = 2015	◦None described	◦Duodenal cancers in surveillance group: 13/27 (48.1%); 77% early stage (I–IIA) ◦Duodenal cancers in diagnostic group: 14/27 (51.9%); 29% early stage (I–IIA)	◦ EGD surveillance associated with: ◦ Early detection of duodenal cancers
Galiatsatos [72] 2017 Turkey	Retrospective Indication for EGD: not specified N = 21	◦H pylori: 9.5% ◦Atrophic gastritis: 0% ◦GIM: 9.5%	◦No cancers identified	◦ EGD surveillance not associated with: ◦ Detection of upper gastrointestinal cancers
Renkonen-Sinisalo [73] 2002 Finland	Prospective one-time EGD, case–control study including gastric biopsy N = 73 with Lynch syndrome and 32 mutation-negative family members	◦Case/Control ◦H pylori: 26/28% ◦Atrophic gastritis: 14/22% ◦GIM: 14/19%	◦Duodenal cancer: 1.4% (1/105)	◦ EGD surveillance not associated with: ◦ Detection of early stage cancer ◦ Detection of premalignant lesions
Ladigan-Badura S [46] 2021 Germany	Review of gastric cancer cases in the German Consortium for Familial Intestinal Cancer Registry Indication for EGD: symptoms or surveillance N = 1128	◦None described	◦Gastric cancer: 2.3% (47/2009) ◦6/22 patients had cancer detected on surveillance; 83% Stage I ◦16/22 patients with no surveillance had cancer diagnosed; 25% Stage I	◦ Surveillance EGD associated with: ◦ Early-stage cancer detection
Hammoudi [62] 2019 France	Retrospective, Assessment of duodenal neoplasia on EGD or push EGD Indication for EGD: not specified N = 154	◦Duodenal adenomas: 1.9%	◦Duodenal cancer: 2.6% (4/154) ◦75% of patients with duodenal cancer diagnosed at advanced stage	◦ Surveillance EGD associated with: ◦ Detection of pre-cancerous and cancerous duodenal lesions

BE: Barrett’s esophagus; GIM: gastric intestinal metaplasia; NET: neuroendocrine tumor; EGD: Esophagogastroduodenoscopy.