{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T01:07:00Z","timestamp":1788916020198,"version":"build-2803163510"},"reference-count":83,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":76,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Polyposis syndromes contribute to a significant proportion of colorectal cancer (CRC) diagnoses. While Lynch syndrome (LS) and familial adenomatous polyposis (FAP) are well characterised, a growing number of rarer polyposis syndromes are increasingly recognised in clinical practice. These conditions often present with overlapping phenotypes and variable penetrance, posing diagnostic and management challenges for the practising clinician. The evidence base remains limited, with current guidance largely derived from small cohort studies and expert opinion. This narrative review summarises the current literature on the genetic basis, clinical manifestations, and endoscopic features of the rarer colorectal polyposis syndromes, excluding LS and FAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive literature search was conducted using PubMed and Ovid databases. Selected articles were evaluated for relevance and quality, and key findings were synthesised narratively to provide an overview of current knowledge and emerging trends relating to the rarer polyposis syndromes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This review consolidates international recommendations for surveillance and management, with a focus on practical guidance for the endoscopist. Advances in next-generation sequencing and multigene panel testing have reshaped our understanding of polyposis genetics, leading to the identification of several novel autosomal dominant and recessive syndromes. Despite these discoveries, surveillance protocols remain heterogeneous, and gaps persist in defining cancer risk, optimal timing of intervention, and the role of chemoprevention. Greater awareness of these syndromes among clinicians is essential for timely diagnosis and personalised management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Collaborative registries, prospective data, and consensus-driven guidelines are urgently required to standardise care and improve outcomes for patients with rare polyposis syndromes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-026-05186-8","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T06:55:58Z","timestamp":1782370558000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The \u2018other\u2019 colonic polyposis syndromes\u2014evolving insights and guidance for endoscopists"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3180-383X","authenticated-orcid":false,"given":"Amanda","family":"Liesegang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Heriot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"issue":"5","key":"5186_CR1","doi-asserted-by":"publisher","first-page":"98629","DOI":"10.3748\/wjg.v31.i5.98629","volume":"31","author":"VV Tsukanov","year":"2025","unstructured":"Tsukanov VV, Vasyutin AV, Tonkikh JL (2025) Risk factors, prevention and screening of colorectal cancer: a rising problem. World J Gastroenterol 31(5):98629. https:\/\/doi.org\/10.3748\/wjg.v31.i5.98629","journal-title":"World J Gastroenterol"},{"issue":"1","key":"5186_CR2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S1470-2045(24)00600-4","volume":"26","author":"H Sung","year":"2025","unstructured":"Sung H, Siegel RL, Laversanne M et al (2025) Colorectal cancer incidence trends in younger versus older adults: an analysis of population-based cancer registry data. Lancet Oncol 26(1):51\u201363. https:\/\/doi.org\/10.1016\/S1470-2045(24)00600-4","journal-title":"Lancet Oncol"},{"issue":"2","key":"5186_CR3","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/ajg.2014.435","volume":"110","author":"S Syngal","year":"2015","unstructured":"Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW (2015) ACG clinical guideline: genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol 110(2):223\u201362. https:\/\/doi.org\/10.1038\/ajg.2014.435","journal-title":"Am J Gastroenterol"},{"issue":"6","key":"5186_CR4","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1016\/j.gie.2022.02.044","volume":"95","author":"CR Boland","year":"2022","unstructured":"Boland CR, Idos GE, Durno C et al (2022) Diagnosis and management of cancer risk in the gastrointestinal hamartomatous polyposis syndromes: recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc 95(6):1025\u201347. https:\/\/doi.org\/10.1016\/j.gie.2022.02.044","journal-title":"Gastrointest Endosc"},{"issue":"7","key":"5186_CR5","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1136\/gutjnl-2015-310784","volume":"66","author":"IJ Jeg","year":"2017","unstructured":"Jeg IJ, Bevan R, Senore C et al (2017) Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut 66(7):1225\u201332. https:\/\/doi.org\/10.1136\/gutjnl-2015-310784","journal-title":"Gut"},{"issue":"2","key":"5186_CR6","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1111\/his.13975","volume":"76","author":"ID Nagtegaal","year":"2020","unstructured":"Nagtegaal ID, Odze RD, Klimstra D et al (2020) The 2019 WHO classification of tumours of the digestive system. Histopathology 76(2):182\u2013188. https:\/\/doi.org\/10.1111\/his.13975","journal-title":"Histopathology"},{"issue":"3","key":"5186_CR7","doi-asserted-by":"publisher","first-page":"358","DOI":"10.5217\/ir.2018.16.3.358","volume":"16","author":"SY Kim","year":"2018","unstructured":"Kim SY, Kim TI (2018) Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis. Intest Res 16(3):358\u2013365. https:\/\/doi.org\/10.5217\/ir.2018.16.3.358","journal-title":"Intest Res"},{"issue":"4","key":"5186_CR8","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1007\/s11938-019-00256-z","volume":"17","author":"PP Stanich","year":"2019","unstructured":"Stanich PP, Pearlman R (2019) Hereditary or not? Understanding serrated polyposis syndrome. Curr Treat Options Gastroenterol 17(4):692\u2013701. https:\/\/doi.org\/10.1007\/s11938-019-00256-z","journal-title":"Curr Treat Options Gastroenterol"},{"issue":"4","key":"5186_CR9","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1053\/j.gastro.2019.06.041","volume":"157","author":"SD Crockett","year":"2019","unstructured":"Crockett SD, Nagtegaal ID (2019) Terminology, molecular features, epidemiology, and management of serrated colorectal neoplasia. Gastroenterology 157(4):949\u201366.e4. https:\/\/doi.org\/10.1053\/j.gastro.2019.06.041","journal-title":"Gastroenterology"},{"issue":"3","key":"5186_CR10","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1136\/gutjnl-2019-319915","volume":"69","author":"KJ Monahan","year":"2020","unstructured":"Monahan KJ, Bradshaw N, Dolwani S et al (2020) Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)\/Association of Coloproctology of Great Britain and Ireland (ACPGBI)\/United Kingdom Cancer Genetics Group (UKCGG). Gut 69(3):411\u2013444. https:\/\/doi.org\/10.1136\/gutjnl-2019-319915","journal-title":"Gut"},{"issue":"1","key":"5186_CR11","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1097\/MOG.0000000000000495","volume":"35","author":"CR Lindholm","year":"2019","unstructured":"Lindholm CR, Anderson JC, Srivastava A (2019) The dark side of the colon: current issues surrounding the significance, prevalence, detection, diagnosis and management of serrated polyps. Curr Opin Gastroenterol 35(1):34\u201341. https:\/\/doi.org\/10.1097\/MOG.0000000000000495","journal-title":"Curr Opin Gastroenterol"},{"issue":"3","key":"5186_CR12","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/j.cgh.2021.05.057","volume":"20","author":"C Muller","year":"2022","unstructured":"Muller C, Yamada A, Ikegami S et al (2022) Risk of colorectal cancer in serrated polyposis syndrome: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 20(3):622\u201330 e7. https:\/\/doi.org\/10.1016\/j.cgh.2021.05.057","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"2","key":"5186_CR13","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.bpg.2013.03.012","volume":"27","author":"BV Naini","year":"2013","unstructured":"Naini BV, Odze RD (2013) Advanced precancerous lesions (APL) in the colonic mucosa. Best Pract Res Clin Gastroenterol 27(2):235\u2013256. https:\/\/doi.org\/10.1016\/j.bpg.2013.03.012","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"2","key":"5186_CR14","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.cgh.2008.08.031","volume":"7","author":"AO Laiyemo","year":"2009","unstructured":"Laiyemo AO, Murphy G, Sansbury LB et al (2009) Hyperplastic polyps and the risk of adenoma recurrence in the polyp prevention trial. Clin Gastroenterol Hepatol 7(2):192\u2013197. https:\/\/doi.org\/10.1016\/j.cgh.2008.08.031","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"9","key":"5186_CR15","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1055\/a-0965-0605","volume":"51","author":"ME van Leerdam","year":"2019","unstructured":"van Leerdam ME, Roos VH, van Hooft JE et al (2019) Endoscopic management of polyposis syndromes: European Society of Gastrointestinal Endoscopy (ESGE) guideline. Endoscopy 51(9):877\u2013895. https:\/\/doi.org\/10.1055\/a-0965-0605","journal-title":"Endoscopy"},{"issue":"7","key":"5186_CR16","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1136\/gutjnl-2017-314005","volume":"66","author":"JE East","year":"2017","unstructured":"East JE, Atkin WS, Bateman AC et al (2017) British Society of Gastroenterology position statement on serrated polyps in the colon and rectum. Gut 66(7):1181\u20131196. https:\/\/doi.org\/10.1136\/gutjnl-2017-314005","journal-title":"Gut"},{"issue":"6","key":"5186_CR17","doi-asserted-by":"publisher","first-page":"730","DOI":"10.5858\/arpa.2014-0424-RA","volume":"139","author":"HM Yang","year":"2015","unstructured":"Yang HM, Mitchell JM, Sepulveda JL, Sepulveda AR (2015) Molecular and histologic considerations in the assessment of serrated polyps. Arch Pathol Lab Med 139(6):730\u2013741. https:\/\/doi.org\/10.5858\/arpa.2014-0424-RA","journal-title":"Arch Pathol Lab Med"},{"issue":"9","key":"5186_CR18","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s11894-013-0342-4","volume":"15","author":"M Tadros","year":"2013","unstructured":"Tadros M, Anderson JC (2013) Serrated polyps: clinical implications and future directions. Curr Gastroenterol Rep 15(9):342. https:\/\/doi.org\/10.1007\/s11894-013-0342-4","journal-title":"Curr Gastroenterol Rep"},{"issue":"6","key":"5186_CR19","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1053\/j.gastro.2010.01.054","volume":"138","author":"KW Jasperson","year":"2010","unstructured":"Jasperson KW, Tuohy TM, Neklason DW, Burt RW (2010) Hereditary and familial colon cancer. Gastroenterology 138(6):2044\u20132058. https:\/\/doi.org\/10.1053\/j.gastro.2010.01.054","journal-title":"Gastroenterology"},{"issue":"2","key":"5186_CR20","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1111\/jgh.13482","volume":"32","author":"K Okamoto","year":"2017","unstructured":"Okamoto K, Kitamura S, Kimura T et al (2017) Clinicopathological characteristics of serrated polyps as precursors to colorectal cancer: current status and management. J Gastroenterol Hepatol 32(2):358\u2013367. https:\/\/doi.org\/10.1111\/jgh.13482","journal-title":"J Gastroenterol Hepatol"},{"issue":"1","key":"5186_CR21","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1136\/gutjnl-2018-318134","volume":"69","author":"AG Bleijenberg","year":"2020","unstructured":"Bleijenberg AG, Je IJ, van Herwaarden YJ et al (2020) Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study. Gut 69(1):112\u201321. https:\/\/doi.org\/10.1136\/gutjnl-2018-318134","journal-title":"Gut"},{"issue":"Suppl 2","key":"5186_CR22","doi-asserted-by":"publisher","first-page":"17","DOI":"10.20471\/acc.2021.60.s2.01","volume":"60","author":"N Ljubicic","year":"2021","unstructured":"Ljubicic N, Poropat G, Antoljak N et al (2021) Opportunistic screening for colorectal cancer in high-risk patients in family medicine practices in the Republic of Croatia. Acta Clin Croat 60(Suppl 2):17\u201326. https:\/\/doi.org\/10.20471\/acc.2021.60.s2.01","journal-title":"Acta Clin Croat"},{"issue":"6","key":"5186_CR23","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1586\/17474124.2015.1026328","volume":"9","author":"T Sammour","year":"2015","unstructured":"Sammour T, Hayes IP, Hill AG, Macrae FA, Winter DC (2015) Familial colorectal cancer syndromes: an overview of clinical management. Expert Rev Gastroenterol Hepatol 9(6):757\u2013764. https:\/\/doi.org\/10.1586\/17474124.2015.1026328","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"5186_CR24","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2022.101791","volume":"58","author":"S Carballal","year":"2022","unstructured":"Carballal S, Balaguer F, Jeg IJ (2022) Serrated polyposis syndrome; epidemiology and management. Best Pract Res Clin Gastroenterol 58:101791. https:\/\/doi.org\/10.1016\/j.bpg.2022.101791","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"5","key":"5186_CR25","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/MOP.0000000000001044","volume":"33","author":"C Phen","year":"2021","unstructured":"Phen C, Rojas I (2021) Paediatric polyposis syndromes: burden of disease and current concepts. Curr Opin Pediatr 33(5):509\u2013514. https:\/\/doi.org\/10.1097\/MOP.0000000000001044","journal-title":"Curr Opin Pediatr"},{"issue":"3","key":"5186_CR26","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1097\/MPG.0000000000002248","volume":"68","author":"A Latchford","year":"2019","unstructured":"Latchford A, Cohen S, Auth M et al (2019) Management of Peutz-Jeghers syndrome in children and adolescents: a position paper from the ESPGHAN polyposis working group. J Pediatr Gastroenterol Nutr 68(3):442\u2013452. https:\/\/doi.org\/10.1097\/MPG.0000000000002248","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"4","key":"5186_CR27","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1007\/s11938-019-00251-4","volume":"17","author":"TD Kidambi","year":"2019","unstructured":"Kidambi TD, Kohli DR, Samadder NJ, Singh A (2019) Hereditary polyposis syndromes. Curr Treat Options Gastroenterol 17(4):650\u2013665. https:\/\/doi.org\/10.1007\/s11938-019-00251-4","journal-title":"Curr Treat Options Gastroenterol"},{"issue":"6","key":"5186_CR28","doi-asserted-by":"publisher","first-page":"1258","DOI":"10.1038\/ajg.2009.725","volume":"105","author":"MG van Lier","year":"2010","unstructured":"van Lier MG, Wagner A, Mathus-Vliegen EM, Kuipers EJ, Steyerberg EW, van Leerdam ME (2010) High cancer risk in Peutz-Jeghers syndrome: a systematic review and surveillance recommendations. Am J Gastroenterol 105(6):1258\u201364. https:\/\/doi.org\/10.1038\/ajg.2009.725","journal-title":"Am J Gastroenterol"},{"issue":"2","key":"5186_CR29","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.ejso.2016.07.008","volume":"43","author":"RP Kennelly","year":"2017","unstructured":"Kennelly RP, Gryfe R, Winter DC (2017) Familial colorectal cancer: patient assessment, surveillance and surgical management. Eur J Surg Oncol 43(2):294\u2013302. https:\/\/doi.org\/10.1016\/j.ejso.2016.07.008","journal-title":"Eur J Surg Oncol"},{"key":"5186_CR30","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030473","author":"A Wagner","year":"2021","unstructured":"Wagner A, Aretz S, Auranen A et al (2021) The management of Peutz-Jeghers syndrome: European Hereditary Tumour Group (EHTG) guideline. J Clin Med. https:\/\/doi.org\/10.3390\/jcm10030473","journal-title":"J Clin Med"},{"issue":"5","key":"5186_CR31","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1097\/MOP.0000000000000265","volume":"27","author":"M Kay","year":"2015","unstructured":"Kay M, Eng K, Wyllie R (2015) Colonic polyps and polyposis syndromes in pediatric patients. Curr Opin Pediatr 27(5):634\u2013641. https:\/\/doi.org\/10.1097\/MOP.0000000000000265","journal-title":"Curr Opin Pediatr"},{"issue":"44","key":"5186_CR32","doi-asserted-by":"publisher","first-page":"4839","DOI":"10.3748\/wjg.v17.i44.4839","volume":"17","author":"LA Brosens","year":"2011","unstructured":"Brosens LA, Langeveld D, van Hattem WA, Giardiello FM, Offerhaus GJ (2011) Juvenile polyposis syndrome. World J Gastroenterol 17(44):4839\u20134844. https:\/\/doi.org\/10.3748\/wjg.v17.i44.4839","journal-title":"World J Gastroenterol"},{"key":"5186_CR33","doi-asserted-by":"publisher","unstructured":"Dal Buono A, Gaiani F, Poliani L, Laghi L (2022) Juvenile polyposis syndrome: an overview. Best Pract Res Clin Gastroenterol 59. https:\/\/doi.org\/10.1016\/j.bpg.2022.101799","DOI":"10.1016\/j.bpg.2022.101799"},{"issue":"10","key":"5186_CR34","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1097\/DCR.0b013e31826278b3","volume":"55","author":"AR Latchford","year":"2012","unstructured":"Latchford AR, Neale K, Phillips RK, Clark SK (2012) Juvenile polyposis syndrome: a study of genotype, phenotype, and long-term outcome. Dis Colon Rectum 55(10):1038\u20131043. https:\/\/doi.org\/10.1097\/DCR.0b013e31826278b3","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"5186_CR35","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1097\/MPG.0000000000002246","volume":"68","author":"S Cohen","year":"2019","unstructured":"Cohen S, Hyer W, Mas E et al (2019) Management of juvenile polyposis syndrome in children and adolescents: a position paper from the ESPGHAN Polyposis Working Group. J Pediatr Gastroenterol Nutr 68(3):453\u2013462. https:\/\/doi.org\/10.1097\/MPG.0000000000002246","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"2","key":"5186_CR36","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1158\/1940-6207.CAPR-20-0348","volume":"14","author":"SP MacFarland","year":"2021","unstructured":"MacFarland SP, Ebrahimzadeh JE, Zelley K et al (2021) Phenotypic differences in juvenile polyposis syndrome with or without a disease-causing SMAD4\/BMPR1A variant. Cancer Prev Res 14(2):215\u2013222. https:\/\/doi.org\/10.1158\/1940-6207.CAPR-20-0348","journal-title":"Cancer Prev Res"},{"issue":"5","key":"5186_CR37","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1053\/j.gastro.2023.01.026","volume":"164","author":"L Yehia","year":"2023","unstructured":"Yehia L, Heald B, Eng C (2023) Clinical spectrum and science behind the hamartomatous polyposis syndromes. Gastroenterology 164(5):800\u2013811. https:\/\/doi.org\/10.1053\/j.gastro.2023.01.026","journal-title":"Gastroenterology"},{"issue":"21","key":"5186_CR38","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1093\/jnci\/djt277","volume":"105","author":"R Pilarski","year":"2013","unstructured":"Pilarski R, Burt R, Kohlman W, Pho L, Shannon KM, Swisher E (2013) Cowden syndrome and the PTEN hamartoma tumor syndrome: systematic review and revised diagnostic criteria. J Natl Cancer Inst 105(21):1607\u20131616. https:\/\/doi.org\/10.1093\/jnci\/djt277","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"5186_CR39","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1038\/sj.ejhg.5200289","volume":"7","author":"MR Nelen","year":"1999","unstructured":"Nelen MR, Kremer H, Konings IB et al (1999) Novel PTEN mutations in patients with Cowden disease: absence of clear genotype-phenotype correlations. Eur J Hum Genet 7(3):267\u2013273. https:\/\/doi.org\/10.1038\/sj.ejhg.5200289","journal-title":"Eur J Hum Genet"},{"issue":"1","key":"5186_CR40","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.ajhg.2010.11.013","volume":"88","author":"MH Tan","year":"2011","unstructured":"Tan MH, Mester J, Peterson C et al (2011) A clinical scoring system for selection of patients for PTEN mutation testing is proposed on the basis of a prospective study of 3042 probands. Am J Hum Genet 88(1):42\u201356. https:\/\/doi.org\/10.1016\/j.ajhg.2010.11.013","journal-title":"Am J Hum Genet"},{"issue":"11","key":"5186_CR41","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1136\/jmg.37.11.828","volume":"37","author":"C Eng","year":"2000","unstructured":"Eng C (2000) Will the real Cowden syndrome please stand up: revised diagnostic criteria. J Med Genet 37(11):828\u2013830. https:\/\/doi.org\/10.1136\/jmg.37.11.828","journal-title":"J Med Genet"},{"issue":"1","key":"5186_CR42","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.ajhg.2012.10.021","volume":"92","author":"MS Orloff","year":"2013","unstructured":"Orloff MS, He X, Peterson C et al (2013) Germline PIK3CA and AKT1 mutations in Cowden and Cowden-like syndromes. Am J Hum Genet 92(1):76\u201380. https:\/\/doi.org\/10.1016\/j.ajhg.2012.10.021","journal-title":"Am J Hum Genet"},{"issue":"11","key":"5186_CR43","doi-asserted-by":"publisher","DOI":"10.1038\/ctg.2011.4","volume":"2","author":"Z Levi","year":"2011","unstructured":"Levi Z, Baris HN, Kedar I et al (2011) Upper and lower gastrointestinal findings in PTEN mutation-positive Cowden syndrome patients participating in an active surveillance program. Clin Transl Gastroenterol 2(11):e5. https:\/\/doi.org\/10.1038\/ctg.2011.4","journal-title":"Clin Transl Gastroenterol"},{"issue":"10","key":"5186_CR44","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1038\/s41431-020-0651-7","volume":"28","author":"M-O Tischkowitz","year":"2020","unstructured":"Tischkowitz M-O, Colas C, Pouwels S, Hoogerbrugge N (2020) Cancer surveillance guideline for individuals with PTEN hamartoma tumour syndrome. Eur J Hum Genet 28(10):1387\u201393. https:\/\/doi.org\/10.1038\/s41431-020-0651-7","journal-title":"Eur J Hum Genet"},{"issue":"2","key":"5186_CR45","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s10689-025-00460-0","volume":"24","author":"JE Joo","year":"2025","unstructured":"Joo JE, Viana-Errasti J, Buchanan DD, Valle L (2025) Genetics, genomics and clinical features of adenomatous polyposis. Fam Cancer 24(2):38. https:\/\/doi.org\/10.1007\/s10689-025-00460-0","journal-title":"Fam Cancer"},{"issue":"8","key":"5186_CR46","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1038\/gim.2017.185","volume":"20","author":"DD Buchanan","year":"2018","unstructured":"Buchanan DD, Stewart JR, Clendenning M et al (2018) Risk of colorectal cancer for carriers of a germ-line mutation in POLE or POLD1. Genet Med 20(8):890\u2013895. https:\/\/doi.org\/10.1038\/gim.2017.185","journal-title":"Genet Med"},{"issue":"2","key":"5186_CR47","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1007\/s10689-021-00256-y","volume":"21","author":"C Palles","year":"2022","unstructured":"Palles C, Martin L, Domingo E et al (2022) The clinical features of polymerase proof-reading associated polyposis (PPAP) and recommendations for patient management. Fam Cancer 21(2):197\u2013209. https:\/\/doi.org\/10.1007\/s10689-021-00256-y","journal-title":"Fam Cancer"},{"issue":"3","key":"5186_CR48","doi-asserted-by":"publisher","first-page":"05","DOI":"10.1093\/bjsopen\/zrad023","volume":"7","author":"TT Seppala","year":"2023","unstructured":"Seppala TT, Burkhart RA, Katona BW (2023) Hereditary colorectal, gastric, and pancreatic cancer: comprehensive review. BJS Open 7(3):05. https:\/\/doi.org\/10.1093\/bjsopen\/zrad023","journal-title":"BJS Open"},{"issue":"4","key":"5186_CR49","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1038\/gim.2015.75","volume":"18","author":"F Bellido","year":"2016","unstructured":"Bellido F, Pineda M, Aiza G et al (2016) POLE and POLD1 mutations in 529 kindred with familial colorectal cancer and\/or polyposis: review of reported cases and recommendations for genetic testing and surveillance. Genet Med 18(4):325\u2013332. https:\/\/doi.org\/10.1038\/gim.2015.75","journal-title":"Genet Med"},{"key":"5186_CR50","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znae070","author":"G Zaffaroni","year":"2024","unstructured":"Zaffaroni G, Mannucci A, Koskenvuo L et al (2024) Updated European guidelines for clinical management of familial adenomatous polyposis (FAP), MUTYH-associated polyposis (MAP), gastric adenocarcinoma, proximal polyposis of the stomach (GAPPS) and other rare adenomatous polyposis syndromes: a joint EHTG-ESCP revision. Br J Surg. https:\/\/doi.org\/10.1093\/bjs\/znae070","journal-title":"Br J Surg"},{"issue":"6","key":"5186_CR51","doi-asserted-by":"publisher","DOI":"10.1002\/mgg3.2157","volume":"11","author":"L Roht","year":"2023","unstructured":"Roht L, Hyldebrandt HK, Stormorken AT et al (2023) AXIN2-related oligodontia-colorectal cancer syndrome with cleft palate as a possible new feature. Mol Genet Genomic Med 11(6):e2157. https:\/\/doi.org\/10.1002\/mgg3.2157","journal-title":"Mol Genet Genomic Med"},{"issue":"5","key":"5186_CR52","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1086\/386293","volume":"74","author":"L Lammi","year":"2004","unstructured":"Lammi L, Arte S, Somer M et al (2004) Mutations in AXIN2 cause familial tooth agenesis and predispose to colorectal cancer. Am J Hum Genet 74(5):1043\u20131050. https:\/\/doi.org\/10.1086\/386293","journal-title":"Am J Hum Genet"},{"issue":"3","key":"5186_CR53","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s10689-019-00120-0","volume":"18","author":"C Beard","year":"2019","unstructured":"Beard C, Purvis R, Winship IM, Macrae FA, Buchanan DD (2019) Phenotypic confirmation of oligodontia, colorectal polyposis and cancer in a family carrying an exon 7 nonsense variant in the AXIN2 gene. Fam Cancer 18(3):311\u2013315. https:\/\/doi.org\/10.1007\/s10689-019-00120-0","journal-title":"Fam Cancer"},{"issue":"5","key":"5186_CR54","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1136\/gut.2010.229104","volume":"61","author":"MH Nieuwenhuis","year":"2012","unstructured":"Nieuwenhuis MH, Vogt S, Jones N et al (2012) Evidence for accelerated colorectal adenoma\u2013carcinoma progression in MUTYH-associated polyposis? Gut 61(5):734\u2013738. https:\/\/doi.org\/10.1136\/gut.2010.229104","journal-title":"Gut"},{"issue":"3","key":"5186_CR55","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1007\/s10620-014-3465-z","volume":"60","author":"NJ Samadder","year":"2015","unstructured":"Samadder NJ, Jasperson K, Burt RW (2015) Hereditary and common familial colorectal cancer: evidence for colorectal screening. Dig Dis Sci 60(3):734\u2013747. https:\/\/doi.org\/10.1007\/s10620-014-3465-z","journal-title":"Dig Dis Sci"},{"issue":"2","key":"5186_CR56","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.jviscsurg.2019.12.003","volume":"157","author":"B Menahem","year":"2020","unstructured":"Menahem B, Alves A, Regimbeau JM, Sabbagh C (2020) Colorectal family polyadenomatous diseases. What management in 2020? J Visc Surg 157(2):127\u201335. https:\/\/doi.org\/10.1016\/j.jviscsurg.2019.12.003","journal-title":"J Visc Surg"},{"issue":"12","key":"5186_CR57","doi-asserted-by":"publisher","first-page":"1875","DOI":"10.1038\/sj.bjc.6605966","volume":"103","author":"E Theodoratou","year":"2010","unstructured":"Theodoratou E, Campbell H, Tenesa A et al (2010) A large-scale meta-analysis to refine colorectal cancer risk estimates associated with MUTYH variants. Br J Cancer 103(12):1875\u20131884. https:\/\/doi.org\/10.1038\/sj.bjc.6605966","journal-title":"Br J Cancer"},{"issue":"6","key":"5186_CR58","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1053\/j.gastro.2009.08.052","volume":"137","author":"S Vogt","year":"2009","unstructured":"Vogt S, Jones N, Christian D et al (2009) Expanded extracolonic tumor spectrum in MUTYH-associated polyposis. Gastroenterology 137(6):1976\u201385 e1. https:\/\/doi.org\/10.1053\/j.gastro.2009.08.052","journal-title":"Gastroenterology"},{"issue":"4","key":"5186_CR59","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1053\/j.gastro.2008.12.050","volume":"136","author":"SP Cleary","year":"2009","unstructured":"Cleary SP, Cotterchio M, Jenkins MA et al (2009) Germline MutY human homologue mutations and colorectal cancer: a multisite case-control study. Gastroenterology 136(4):1251\u20131260. https:\/\/doi.org\/10.1053\/j.gastro.2008.12.050","journal-title":"Gastroenterology"},{"issue":"10","key":"5186_CR60","doi-asserted-by":"publisher","first-page":"163","DOI":"10.3238\/arztebl.2010.0163","volume":"107","author":"S Aretz","year":"2010","unstructured":"Aretz S (2010) The differential diagnosis and surveillance of hereditary gastrointestinal polyposis syndromes. Dtsch Arztebl Int 107(10):163\u2013173. https:\/\/doi.org\/10.3238\/arztebl.2010.0163","journal-title":"Dtsch Arztebl Int"},{"issue":"4","key":"5186_CR61","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.gie.2018.04.2347","volume":"88","author":"JJ Hurley","year":"2018","unstructured":"Hurley JJ, Thomas LE, Walton SJ et al (2018) The impact of chromoendoscopy for surveillance of the duodenum in patients with MUTYH-associated polyposis and familial adenomatous polyposis. Gastrointest Endosc 88(4):665\u2013673. https:\/\/doi.org\/10.1016\/j.gie.2018.04.2347","journal-title":"Gastrointest Endosc"},{"key":"5186_CR62","doi-asserted-by":"publisher","first-page":"1254908","DOI":"10.3389\/fgene.2023.1254908","volume":"14","author":"C Pinto","year":"2023","unstructured":"Pinto C, Guerra J, Pinheiro M et al (2023) Combined germline and tumor mutation signature testing identifies new families with NTHL1 tumor syndrome. Front Genet 14:1254908. https:\/\/doi.org\/10.3389\/fgene.2023.1254908","journal-title":"Front Genet"},{"key":"#cr-split#-5186_CR63.1","unstructured":"De Voer RM, Nielsen M, Gao W, Kuiper RP, Hoogerbrugge N (2020) NTHL1 tumor syndrome. In: Adam MP, Bick S, MirzaaGM, Pagon RA, Wallace SE, Amemiya A (eds) GeneReviews\u00ae [Internet]. University of Washington,Seattle, Seattle (WA), pp 1993-2026. [updated 2025 Mar 20"},{"key":"#cr-split#-5186_CR63.2","unstructured":"cited 2025 Dec 18]. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK555473\/"},{"issue":"2","key":"5186_CR64","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.ccell.2018.12.011","volume":"35","author":"JE Grolleman","year":"2019","unstructured":"Grolleman JE, de Voer RM, Elsayed FA et al (2019) Mutational signature analysis reveals NTHL1 deficiency to cause a multi-tumor phenotype. Cancer Cell 35(2):256\u201366.e5. https:\/\/doi.org\/10.1016\/j.ccell.2018.12.011","journal-title":"Cancer Cell"},{"issue":"10","key":"5186_CR65","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1038\/s41431-023-01418-5","volume":"31","author":"M Terradas","year":"2023","unstructured":"Terradas M, Gonzalez-Abuin N, Garc\u00eda-Mulero S et al (2023) MBD4-associated neoplasia syndrome: screening of cases with suggestive phenotypes. Eur J Hum Genet 31(10):1185\u20131189. https:\/\/doi.org\/10.1038\/s41431-023-01418-5","journal-title":"Eur J Hum Genet"},{"issue":"2","key":"5186_CR66","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1016\/j.ajhg.2016.06.015","volume":"99","author":"R Adam","year":"2016","unstructured":"Adam R, Spier I, Zhao B et al (2016) Exome sequencing identifies biallelic MSH3 germline mutations as a recessive subtype of colorectal adenomatous polyposis. The American Journal of Human Genetics 99(2):337\u2013351. https:\/\/doi.org\/10.1016\/j.ajhg.2016.06.015","journal-title":"The American Journal of Human Genetics"},{"issue":"12","key":"5186_CR67","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1136\/jmg-2023-109341","volume":"60","author":"MC Villy","year":"2023","unstructured":"Villy MC, Masliah-Planchon J, Schnitzler A et al (2023) MSH3: a confirmed predisposing gene for adenomatous polyposis. J Med Genet 60(12):1198\u20131205. https:\/\/doi.org\/10.1136\/jmg-2023-109341","journal-title":"J Med Genet"},{"issue":"1","key":"5186_CR68","doi-asserted-by":"publisher","DOI":"10.1038\/s41698-024-00511-2","volume":"8","author":"M Koi","year":"2024","unstructured":"Koi M, Leach BH, McGee S, Tseng-Rogenski SS, Burke CA, Carethers JM (2024) Compound heterozygous MSH3 germline variants and associated tumor somatic DNA mismatch repair dysfunction. NPJ Precis Oncol 8(1):12. https:\/\/doi.org\/10.1038\/s41698-024-00511-2","journal-title":"NPJ Precis Oncol"},{"issue":"1","key":"5186_CR69","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s10689-022-00297-x","volume":"22","author":"AS Aelvoet","year":"2023","unstructured":"Aelvoet AS, Hoekman DR, Redeker BJW et al (2023) A large family with MSH3-related polyposis. Fam Cancer 22(1):49\u201354. https:\/\/doi.org\/10.1007\/s10689-022-00297-x","journal-title":"Fam Cancer"},{"issue":"4","key":"5186_CR70","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1111\/cge.14689","volume":"107","author":"KM Johannesen","year":"2025","unstructured":"Johannesen KM, Karstensen JG, Rasmussen A et al (2025) A novel case of biallelic MLH3 variants in a patient with rectal cancer and polyps. Clin Genet 107(4):480\u2013482. https:\/\/doi.org\/10.1111\/cge.14689","journal-title":"Clin Genet"},{"issue":"8","key":"5186_CR71","doi-asserted-by":"publisher","first-page":"1868","DOI":"10.1038\/s41436-018-0405-x","volume":"21","author":"A Olkinuora","year":"2019","unstructured":"Olkinuora A, Nieminen TT, M\u00e5rtensson E et al (2019) Biallelic germline nonsense variant of MLH3 underlies polyposis predisposition. Genet Med 21(8):1868\u20131873. https:\/\/doi.org\/10.1038\/s41436-018-0405-x","journal-title":"Genet Med"},{"issue":"6","key":"5186_CR72","doi-asserted-by":"publisher","first-page":"1605","DOI":"10.1053\/j.gastro.2017.02.011","volume":"152","author":"C Durno","year":"2017","unstructured":"Durno C, Boland CR, Cohen S et al (2017) Recommendations on surveillance and management of biallelic mismatch repair deficiency (BMMRD) syndrome: a consensus statement by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 152(6):1605\u20131614. https:\/\/doi.org\/10.1053\/j.gastro.2017.02.011","journal-title":"Gastroenterology"},{"issue":"5","key":"5186_CR73","doi-asserted-by":"publisher","first-page":"893","DOI":"10.24953\/TURKJPED.2021.05.017","volume":"63","author":"D \u00d6zy\u00f6r\u00fck","year":"2021","unstructured":"\u00d6zy\u00f6r\u00fck D, Cab\u0131 E\u00dc, Ta\u00e7y\u0131ld\u0131z N et al (2021) Cancer and constitutional mismatch repair deficiency syndrome due to homozygous MSH 6 mutation in children with caf\u00e9 au lait spots and review of literature. Turk J Pediatr 63(5):893\u2013902. https:\/\/doi.org\/10.24953\/TURKJPED.2021.05.017","journal-title":"Turk J Pediatr"},{"issue":"6","key":"5186_CR74","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1136\/jmedgenet-2014-102284","volume":"51","author":"K Wimmer","year":"2014","unstructured":"Wimmer K, Kratz CP, Vasen HFA et al (2014) Diagnostic criteria for constitutional mismatch repair deficiency syndrome: suggestions of the European consortium \u2018Care for CMMRD\u2019 (C4CMMRD). J Med Genet 51(6):355\u2013365. https:\/\/doi.org\/10.1136\/jmedgenet-2014-102284","journal-title":"J Med Genet"},{"issue":"11","key":"5186_CR75","doi-asserted-by":"publisher","first-page":"e32","DOI":"10.1158\/1078-0432.CCR-17-0574","volume":"23","author":"U Tabori","year":"2017","unstructured":"Tabori U, Hansford JR, Achatz MI et al (2017) Clinical management and tumor surveillance recommendations of inherited mismatch repair deficiency in childhood. Clin Cancer Res 23(11):e32\u2013e37. https:\/\/doi.org\/10.1158\/1078-0432.CCR-17-0574","journal-title":"Clin Cancer Res"},{"issue":"5","key":"5186_CR76","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1136\/jmedgenet-2013-102238","volume":"51","author":"HFA Vasen","year":"2014","unstructured":"Vasen HFA, Ghorbanoghli Z, Bourdeaut F et al (2014) Guidelines for surveillance of individuals with constitutional mismatch repair-deficiency proposed by the European Consortium \u201cCare for CMMR-D\u201d (C4CMMR-D). J Med Genet 51(5):283\u2013293. https:\/\/doi.org\/10.1136\/jmedgenet-2013-102238","journal-title":"J Med Genet"},{"issue":"12","key":"5186_CR77","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1038\/s41431-024-01708-6","volume":"32","author":"C-O Colas","year":"2024","unstructured":"Colas C-O, Guerrini-Rousseau L, Suerink M-O et al (2024) ERN GENTURIS guidelines on constitutional mismatch repair deficiency diagnosis, genetic counselling, surveillance, quality of life, and clinical management. Eur J Hum Genet 32(12):1526\u201341. https:\/\/doi.org\/10.1038\/s41431-024-01708-6","journal-title":"Eur J Hum Genet"},{"issue":"2","key":"5186_CR78","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1053\/gast.1997.v112.pm9024286","volume":"112","author":"SC Whitelaw","year":"1997","unstructured":"Whitelaw SC, Murday VA, Tomlinson IP et al (1997) Clinical and molecular features of the hereditary mixed polyposis syndrome. Gastroenterology 112(2):327\u2013334. https:\/\/doi.org\/10.1053\/gast.1997.v112.pm9024286","journal-title":"Gastroenterology"},{"issue":"6","key":"5186_CR79","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1038\/ng.2263","volume":"44","author":"E Jaeger","year":"2012","unstructured":"Jaeger E, Leedham S, Lewis A et al (2012) Hereditary mixed polyposis syndrome is caused by a 40-kb upstream duplication that leads to increased and ectopic expression of the BMP antagonist GREM1. Nat Genet 44(6):699\u2013703. https:\/\/doi.org\/10.1038\/ng.2263","journal-title":"Nat Genet"},{"key":"5186_CR80","unstructured":"NCCN (2026) NCCN clinical practice guidelines in oncology (NCCN Guidelines\u00ae): genetic\/familial high-risk assessment- breast, ovarian, pancreatic and prostate [Internet]: National comprehensive cancer network; version 3.2026: [Available from: https:\/\/www.nccn.org]. Accessed 18 Dec 2025"},{"key":"5186_CR81","unstructured":"NCCN (2025) NCCN clinical practice guidelines in oncology (NCCN Guidelines\u00ae): genetic\/familial high-risk assessment- colorectal, endometrial, and gastric [Internet]: National comprehensive cancer network; version 1.2025: [Available from: https:\/\/www.nccn.org]. Accessed 18 Dec 2025"},{"issue":"20","key":"5186_CR82","doi-asserted-by":"publisher","first-page":"4566","DOI":"10.1158\/1078-0432.CCR-24-0953","volume":"30","author":"SP MacFarland","year":"2024","unstructured":"MacFarland SP, Becktell K, Schneider KW et al (2024) pediatric cancer screening in hereditary gastrointestinal cancer risk syndromes: an update from the AACR Childhood Cancer Predisposition Working Group. Clin Cancer Res 30(20):4566\u20134571. https:\/\/doi.org\/10.1158\/1078-0432.CCR-24-0953","journal-title":"Clin Cancer Res"}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-026-05186-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-026-05186-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-026-05186-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:39:04Z","timestamp":1788914344000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-026-05186-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":83,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5186"],"URL":"https:\/\/doi.org\/10.1007\/s00384-026-05186-8","relation":{},"ISSN":["1432-1262"],"issn-type":[{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"21 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This is a narrative review of existing literature. No ethical approval is required.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"146"}}