May 2020 – Substantial progress in research on hereditary colorectal cancer (Lynch syndrome, polyposis, and other syndromes) in Iran and Palestine

Two research projects have recently been started by members of the network. One project in Iran entitled “Clinical and Genetic Assessment of Hereditary Colorectal Cancer Syndromes in Iran” started in 2018, financially supported by the National Institute for Medical Research (NIMAD). The primary investigator is Ladan Goshayeshi MD, Gastroenterologist at the Mashhad University of Medical Sciences who recently established a national Registry for families with hereditary colorectal cancer and polyposis in Mashhad (www.Iranian-hcc.org).

The aims of the study are: (1) to determine the genetic landscape of hereditary CRC syndromes in Iran; (2) to identify novel genes and gene variants involved in hereditary CRC syndromes; (3) to propose a new screening workflow for molecular identification of at-risk individuals and patients with hereditary CRC syndromes and (4) to prepare a national guideline for screening, diagnosis, treatment, and management of hereditary CRCs. On 28 December 2018, a conference has been organised by Dr. Goshayeshi in Mashhad to increase the knowledge on hereditary colorectal cancer and to establish a nationwide collaboration between the Lynch syndrome centers in Mashhad, Tehran, Isfahan and other cities. More than 100 scientists participated in the meeting (picture).

Currently, samples from patients suspected of having Lynch syndrome or polyposis are being collected for genetic testing. The long term goals are: (1) to perform a study with a similar design in every province in Iran; (2) to implement surveillance guidelines based on the regional (molecular) epidemiology of hereditary CRC syndromes; and (3) to deliver effective preventive care to reduce the burden of cancer in Iran.

A second project on hereditary colorectal cancer has been started in 2018 in Palestine supported with a grant from the Al-Quds Academy for Scientific Research. The title of the project is: Genetic Determinants of Colorectal Cancer among Palestinians and the principal investigator is Abu Seir, Rania, Ph.D., Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Abu Dis, Palestine.

The aims of this study are to identify patients with Lynch syndrome using universal screening of CRC with immunohistochemical analysis and to evaluate environmental risk factors. In this case-control study, 200 adult Palestinians with histologically confirmed CRC will be included. Subjects will be recruited through the major hospitals providing treatment to CRC cases. In addition, 200 cancer-free health individuals will be recruited as controls. After consenting, the study subjects will go through a face to face interview to answer a questionnaire targeting all risk factors of CRC including occupation, medical history, family history of cancer, intake of red meat and vegetables, exposure to radiation, smoking and drinking habits. In addition, EDTA-blood samples will be collected for DNA extraction for the purpose of the genetic study.

A successful conference on the prevention of hereditary colorectal cancer was organized by Dr. Abu Seir on 12 January 2019 at the Al-Quds University in Abu Dis (picture). The first results of the project were presented at a second workshop at the Augusta Victoria Hospital in Jerusalem on 13 February 2020.

30 May 2020
Hans FA Vasen, MD, PhD, AGAF
Department of Gastroenterology & Hepatology
Leiden University Medical Centre
Leiden, The Netherlands