Role of new endoscopic techniques in Lynch syndrome

Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), is the most common hereditary condition predisposing for colorectal cancer. International guidelines recommend surveillance of the colorectum by colonoscopy every 1-2 years starting at the age of 20-25 years. This has been shown to reduce the incidence of, and mortality due to colorectal cancer. Aim of this review was to determine the current role of new endoscopic techniques, such as narrow-band imaging, autofluorescence endoscopy and chromoendoscopy in the surveillance of Lynch syndrome. So far, six studies have been published in which the new endoscopic techniques were investigated in Lynch syndrome: narrow-band imaging (n = 1), autofluorescence endoscopy (n = 1) and chromoendoscopy (n = 4). At this moment, none of the new endoscopic techniques have shown clear and convincing superiority over conventional white light colonoscopy in Lynch syndrome subjects. Of these three techniques, chromoendoscopy appears to be the most promising new endoscopic technique in aiding in the detection of neoplastic lesions in Lynch syndrome, although further prospective studies are needed.