On 29 October, Meta van Lanschot from the molecular
pathology group of Gerrit Meijer at the NKI defende her thesis,
entitled 'Early detection of colorectal cancer. Towards better
surveillance'. Meta van Lanschot defended her thesis at
Utrecht University. Promotores: prof. pr. Gerrit Meijer
(AVL) en prof. dr. E. Dekker. Co-promotor: prof.dr. B.
Carvalho. Her research was funded by the Dutch Cancer Society
- Alpe d'Huzes.
Colorectal cancer (CRC) is a large health problem worldwide. In
the Netherlands approximately 14.000 new cases are diagnosed each
year. As such, colorectal cancer is the second most common type of
cancer. The disease develops from precursor lesions, called polyps,
which take an estimated 10 to 15 years to progress to cancer.
During colonoscopy polyps can be detected and removed. If diagnosed
in an early phase, colorectal cancer is often curable and the
treatment burden limited.
Those patients in whom colorectal cancer or advanced adenomas
have previously been detected, are recommended to undergo regular
follow-up colonoscopies. The monitoring of the increased risk
population is called surveillance.
In this thesis, results have been generated that contribute to
the improvement of the surveillance strategy for early detection of
colorectal cancer. On the one hand, molecular changes have been
studied that are associated with the progression from polyp to
cancer. By understanding better which changes in a polyp will
eventually lead to cancer, we may be able to better predict in the
future who does and who does not need colonoscopies. On the other
hand, alternative surveillance strategies have been tested in
clinical practice. Instead of surveillance by colonoscopy, for
example stool tests could be used to select patients with a high
risk of colorectal cancer or advanced polyps. With the new insights
presented, we will hopefully get closer to the implementation of
new surveillance strategies that reduce the number of unnecessary
colonoscopies and increase the cost-effectiveness of the