Dual primary gastric and colorectal cancer: The known hereditary causes and underlying mechanisms

Abstract

In this editorial, I commented on the paper by Lin et al, published in this issue of the World Journal of Gastrointestinal Oncology. The work aimed at analysing the clinicopathologic characteristics and prognosis of synchronous and metachronous cancers in patients with dual primary gastric and colorectal cancer (CRC). The authors concluded the necessity for regular surveillance for metachronous cancer during postoperative follow-up and reported the prognosis is influenced by the gastric cancer (GC) stage rather than the CRC stage. Although surveillance was recommended in the conclusion, the authors did not explore this area in their study and did not include tests used for such surveillance. This editorial focuses on the most characterized gastrointestinal cancer susceptibility syndromes concerning dual gastric and CRCs. These include hereditary diffuse GC, familial adenomatous polyposis, hereditary nonpolyposis colon cancer, Lynch syndrome, and three major hamartomatous polyposis syndromes associated with CRC and GC, namely Peutz-Jeghers syndrome, juvenile polyposis syndrome, and PTEN hamartoma syndrome. Careful assessment of these syndromes/conditions, including inheritance, risk of gastric and colorectal or other cancer development, genetic mutations and recommended genetic investigations, is crucial for optimum management of these patients.

Keywords: Dual gastric cancer and colorectal cancer; Hereditary; Hereditary diffuse gastric cancer; Familial adenomatous polyposis; Hereditary nonpolyposis colon cancer; Lynch syndrome; Other hamartomatous polyposis syndromes

Core Tip: Patients with dual primary synchronous and metachronous primary gastric and colorectal cancer should receive appropriate surveillance measures to minimize their risk of developing syndrome-specific cancers. The genetic testing of diffuse hereditary gastric cancer, familial adenomatous polyposis, hereditary nonpolyposis colon cancer, Lynch syndrome, Peutz-Jeghers syndrome, juvenile polyposis syndrome, and Cowden syndrome should be considered to ensure optimum diagnosis and management.