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Small bowel cancer risk in Lynch syndrome
  1. K Schulmann1,
  2. C Engel2,
  3. P Propping3,
  4. W Schmiegel1
  1. 1Ruhr-University Bochum, Knappschaftskrankenhaus, Bochum, Germany
  2. 2University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Leipzig, Germany
  3. 3University of Bonn, Institute of Human Genetics, Bonn, Germany
  1. Dr K Schulmann, Ruhr-University Bochum, Medical Department, Knappschaftskrankenhaus, Reference Centre Gastroenterology of the German HNPCC Consortium, Bochum, Germany; karsten.schulmann{at}

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We read with great interest the article by ten Kate et al (Gut 2007;56:1198–201) from the Dutch HNPCC group regarding the risk of small bowel cancer (SBC) in patients with hereditary non-polyposis colorectal cancer (HNPCC). The study confirms our data from 20051 regarding the localisation of tumours and the absence of identifiable risk factors for SBC in patients with HNPCC (ie, gender, mutation, family history, personal cancer history). The authors additionally calculated a lifetime risk of 4.2% for SBC using Kaplan–Meier statistics. Ten Kate et al recommend a non-invasive surveillance strategy. However, the authors argue that the lifetime risk for gastric cancer (GC) may influence a surveillance strategy for SBC regarding upper intestinal endoscopy.

In our previous studies1 ,2 cumulative cancer risks were not provided. We …

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  • Funding: The German HNPCC Consortium is funded by the German Cancer Aid (Deutsche Krebshilfe).

  • Competing interests: None.

  • The Reference Centre Gastroenterology of the German HNPCC Consortium is located at the Ruhr-University Bochum. The Central Database and Biometry of the German HNPCC Consortium is located at the University of Leipzig. PP is the spokesman of the German HNPCC Consortium, and WS is the co-spokesman of the German HNPCC Consortium.