{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:01:04Z","timestamp":1793228464437,"version":"4.5.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Familial Cancer"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Lynch syndrome predisposes to multiple cancer types, including urological malignancies. However, no evidence-based recommendations for surveillance of urological malignancies currently exist. In this systematic review, we aim to describe the current evidence regarding surveillance for these cancers. A systematic literature search was conducted using MEDLINE, searching for urological malignancies, Lynch syndrome, and surveillance including the results of the surveillance methods. Sensitivity and specificity were calculated, when possible, preferably for pooled data from each surveillance method. The risk of bias was assessed using the Newcastle\u2013Ottawa Scale. After full text-screening, nine studies published in 2008\u20132025 met the inclusion criteria, including two on prostate cancer and seven on urothelial cancer. Prostate cancer-antigen (PSA) surveillance led to 38 prostate cancer diagnoses in 865 individuals with Lynch syndrome, with 71% being clinically significant prostate cancers. In 1564 individuals, 11 urothelial carcinomas were diagnosed by different surveillance methods and 15 diagnoses were missed. Sensitivity of urinalysis, urine cytology, urine MSI, and CT and cystoscopy was 11%, 30%, 100%, and 100% respectively. Specificity was 90%, 97%, 99%, and 100% respectively for these methods. Further data is needed but for prostate cancer surveillance PSA shows promise, while for\n                    <jats:italic>MSH2<\/jats:italic>\n                    carriers at least, urine microsatellite instability analysis shows promise as a urothelial cancer surveillance test.\n                  <\/jats:p>","DOI":"10.1007\/s10689-026-00560-5","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T06:01:19Z","timestamp":1777010479000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Early detection of urological malignancies in Lynch syndrome: a systematic review"],"prefix":"10.1007","volume":"25","author":[{"given":"B. H. J.","family":"Doornweerd","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. W.","family":"Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"560_CR1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1038\/nm0296-169","volume":"2","author":"B Liu","year":"1996","unstructured":"Liu B, Parsons R, Papadopoulos N et al (1996) Analysis of mismatch repair genes in hereditary non-polyposis colorectal cancer patients. Nat Med 2:169\u2013174. https:\/\/doi.org\/10.1038\/nm0296-169","journal-title":"Nat Med"},{"key":"560_CR2","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/s41436","volume":"22","author":"M Dominguez-Valentin","year":"2020","unstructured":"Dominguez-Valentin M, Sampson JR, Sepp\u00e4l\u00e4 TT et al (2020) Cancer risks by gene, age, and gender in 6350 carriers of pathogenic mismatch repair variants: findings from the Prospective Lynch Syndrome Database. Genet Med 22:15\u201325. https:\/\/doi.org\/10.1038\/s41436","journal-title":"Genet Med"},{"key":"560_CR3","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1016\/j.urology.2015.08.018","volume":"86","author":"P Joost","year":"2015","unstructured":"Joost P, Therkildsen C, Dominguez-Valentin M et al (2015) Urinary tract cancer in Lynch syndrome; increased risk in carriers of MSH2 mutations. Urology 86:1212\u20131217. https:\/\/doi.org\/10.1016\/j.urology.2015.08.018","journal-title":"Urology"},{"key":"560_CR4","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1136\/jmg.2010.076992","volume":"47","author":"RS van der Post","year":"2010","unstructured":"van der Post RS, Kiemeney L, Ligtenberg MJL et al (2010) Risk of urothelial bladder cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers. J Med Genet 47:464\u2013470. https:\/\/doi.org\/10.1136\/jmg.2010.076992","journal-title":"J Med Genet"},{"key":"560_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-016-0130-1","author":"M Dominguez-Valentin","year":"2016","unstructured":"Dominguez-Valentin M, Joost P, Therkildsen C et al (2016) Frequent mismatch-repair defects link prostate cancer to Lynch syndrome. BMC Urol. https:\/\/doi.org\/10.1186\/s12894-016-0130-1","journal-title":"BMC Urol"},{"key":"560_CR6","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1136\/gutjnl-2015-309675","volume":"66","author":"P M\u00f8ller","year":"2017","unstructured":"M\u00f8ller P, Sepp\u00e4l\u00e4 T, Bernstein I et al (2017) Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance: first report from the Prospective Lynch Syndrome Database. Gut 66:464\u2013472. https:\/\/doi.org\/10.1136\/gutjnl-2015-309675","journal-title":"Gut"},{"key":"560_CR7","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1200\/JCO.18.00283","volume":"37","author":"A Latham","year":"2018","unstructured":"Latham A, Srinivasan P, Kemel Y et al (2018) Microsatellite instability is associated with the presence of lynch syndrome pan-cancer. J Clin Oncol 37:286\u2013295. https:\/\/doi.org\/10.1200\/JCO.18.00283","journal-title":"J Clin Oncol"},{"key":"560_CR8","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1038\/bjc.2017.348","volume":"117","author":"C Therkildsen","year":"2017","unstructured":"Therkildsen C, Ladelund S, Smith-Hansen L et al (2017) Towards gene-and gender-based risk estimates in Lynch syndrome; age-specific incidences for 13 extra-colorectal cancer types. Br J Cancer 117:1702\u20131710. https:\/\/doi.org\/10.1038\/bjc.2017.348","journal-title":"Br J Cancer"},{"key":"560_CR9","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1111\/iju.13094","volume":"23","author":"C Therkildsen","year":"2016","unstructured":"Therkildsen C, Joost P, Lindberg LJ et al (2016) Renal cell cancer linked to Lynch syndrome: increased incidence and loss of mismatch repair protein expression. Int J Urol 23:528\u2013529. https:\/\/doi.org\/10.1111\/iju.13094","journal-title":"Int J Urol"},{"key":"560_CR10","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/S1470-2045(21)00522-2","volume":"22","author":"EK Bancroft","year":"2021","unstructured":"Bancroft EK, Page EC, Brook MN et al (2021) A prospective prostate cancer screening programme for men with pathogenic variants in mismatch repair genes (IMPACT): initial results from an international prospective study. Lancet Oncol 22:1618\u20131631. https:\/\/doi.org\/10.1016\/S1470-2045(21)00522-2","journal-title":"Lancet Oncol"},{"key":"560_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.101909","author":"M Dominguez-Valentin","year":"2023","unstructured":"Dominguez-Valentin M, Haupt S, Sepp\u00e4l\u00e4 TT et al (2023) Mortality by age, gene and gender in carriers of pathogenic mismatch repair gene variants receiving surveillance for early cancer diagnosis and treatment: a report from the prospective Lynch syndrome database. EClinicalMedicine. https:\/\/doi.org\/10.1016\/j.eclinm.2023.101909","journal-title":"EClinicalMedicine"},{"key":"560_CR12","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1002\/bjs.11902","volume":"108","author":"TT Sepp\u00e4l\u00e4","year":"2021","unstructured":"Sepp\u00e4l\u00e4 TT, Latchford A, Negoi I et al (2021) European guidelines from the EHTG and ESCP for Lynch syndrome: an updated third edition of the Mallorca guidelines based on gene and gender. Br J Surg 108:484\u2013498. https:\/\/doi.org\/10.1002\/bjs.11902","journal-title":"Br J Surg"},{"key":"560_CR13","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1136\/jmg.2007.048991","volume":"44","author":"HFA Vasen","year":"2007","unstructured":"Vasen HFA, M\u00f6slein G, Alonso A et al (2007) Guidelines for the clinical management of Lynch syndrome (hereditary non-polyposis cancer). J Med Genet 44:353\u2013362. https:\/\/doi.org\/10.1136\/jmg.2007.048991","journal-title":"J Med Genet"},{"key":"560_CR14","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.eururo.2024.03.027","volume":"86","author":"P Cornford","year":"2024","unstructured":"Cornford P, van den Bergh RCN, Briers E et al (2024) EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on prostate cancer\u20142024 update. Part I: screening, diagnosis, and local treatment with curative intent. Eur Urol 86:148\u2013163. https:\/\/doi.org\/10.1016\/j.eururo.2024.03.027","journal-title":"Eur Urol"},{"key":"560_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2025.105969","author":"R Hall","year":"2025","unstructured":"Hall R, Gallon R, Hayes C et al (2025) Detection of urothelial carcinoma in Lynch syndrome using microsatellite instability analysis of urine cell-free DNA. EBioMedicine. https:\/\/doi.org\/10.1016\/j.ebiom.2025.105969","journal-title":"EBioMedicine"},{"key":"560_CR16","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3109\/00365599.2011.599334","volume":"46","author":"P Zachhau","year":"2012","unstructured":"Zachhau P, Walter S (2012) Urinary tract cancer in patients with hereditary non-polyposis colorectal cancer. Scand J Urol Nephrol 46:5\u20137. https:\/\/doi.org\/10.3109\/00365599.2011.599334","journal-title":"Scand J Urol Nephrol"},{"key":"560_CR17","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/j.eururo.2024.07.027","volume":"86","author":"P Gontero","year":"2024","unstructured":"Gontero P, Birtle A, Capoun O et al (2024) European Association of Urology guidelines on non\u2013muscle-invasive bladder cancer (TaT1 and carcinoma in situ)\u2014a summary of the 2024 guidelines update. Eur Urol 86:531\u2013549. https:\/\/doi.org\/10.1016\/j.eururo.2024.07.027","journal-title":"Eur Urol"},{"key":"560_CR18","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.euo.2021.11.001","volume":"5","author":"C Lonati","year":"2022","unstructured":"Lonati C, Necchi A, G\u00f3mez Rivas J et al (2022) Upper tract urothelial carcinoma in the Lynch syndrome tumour spectrum: a comprehensive overview from the European Association of Urology\u2014Young Academic Urologists and the Global Society of Rare Genitourinary Tumors. Eur Urol Oncol 5:30\u201341. https:\/\/doi.org\/10.1016\/j.euo.2021.11.001","journal-title":"Eur Urol Oncol"},{"key":"560_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4","author":"M Ouzzani","year":"2016","unstructured":"Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A (2016) Rayyan-a web and mobile app for systematic reviews. Syst Rev. https:\/\/doi.org\/10.1186\/s13643-016-0384-4","journal-title":"Syst Rev"},{"key":"560_CR20","unstructured":"Wells G, Shea B, O\u2019Connell D, et al The Newcastle\u2013Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. In: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp,"},{"key":"560_CR21","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-016-2573-x","author":"L Kerr","year":"2016","unstructured":"Kerr L, Rewhorn MJ, Longmuir M et al (2016) A cohort analysis of men with a family history of BRCA1\/2 and Lynch mutations for prostate cancer. BMC Cancer. https:\/\/doi.org\/10.1186\/s12885-016-2573-x","journal-title":"BMC Cancer"},{"key":"560_CR22","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1002\/pros.24711","volume":"84","author":"EM Grindedal","year":"2024","unstructured":"Grindedal EM, Zucknick M, Stormorken A et al (2024) Outcomes of 10 years of PSA screening for prostate cancer in Norwegian men with Lynch syndrome. Prostate 84:945\u2013953. https:\/\/doi.org\/10.1002\/pros.24711","journal-title":"Prostate"},{"key":"560_CR23","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.5306\/wjco.v12.i11.1023","volume":"12","author":"J DeJesse","year":"2021","unstructured":"DeJesse J, Vajravelu RK, Dudzik C et al (2021) Uptake and outcomes of small intestinal and urinary tract cancer surveillance in Lynch syndrome. World J Clin Oncol 12:1023\u20131036. https:\/\/doi.org\/10.5306\/wjco.v12.i11.1023","journal-title":"World J Clin Oncol"},{"key":"560_CR24","doi-asserted-by":"publisher","first-page":"65A","DOI":"10.17159\/2078-5151\/2021\/v59n2a3311","volume":"59","author":"KD Pluke","year":"2021","unstructured":"Pluke KD, Kaestner L (2021) Lessons from a pilot study of screening for upper tract urothelial cell carcinoma in Lynch syndrome. S Afr J Surg 59:65A-65D. https:\/\/doi.org\/10.17159\/2078-5151\/2021\/v59n2a3311","journal-title":"S Afr J Surg"},{"key":"560_CR25","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s10689-008-9193-9","volume":"7","author":"T Myrh\u00f8j","year":"2008","unstructured":"Myrh\u00f8j T, Andersen MB, Bernstein I (2008) Screening for urinary tract cancer with urine cytology in Lynch syndrome and familial colorectal cancer. Fam Cancer 7:303\u2013307. https:\/\/doi.org\/10.1007\/s10689-008-9193-9","journal-title":"Fam Cancer"},{"key":"560_CR26","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-025-00503-6","author":"BHJ Doornweerd","year":"2025","unstructured":"Doornweerd BHJ, Kikkert RR, Koornstra JJ et al (2025) Current surveillance in the Netherlands for urothelial carcinoma in lynch syndrome. Fam Cancer. https:\/\/doi.org\/10.1007\/s10689-025-00503-6","journal-title":"Fam Cancer"},{"key":"560_CR27","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/DCR.0000000000002062","volume":"65","author":"H Chouhan","year":"2022","unstructured":"Chouhan H, Abbass MA, Hrabe JE et al (2022) Evaluation of urinalysis-based screening for urothelial carcinoma in patients with Lynch syndrome. Dis Colon Rectum 65:40\u201345. https:\/\/doi.org\/10.1097\/DCR.0000000000002062","journal-title":"Dis Colon Rectum"},{"key":"560_CR28","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1056\/nejmoa2503223","volume":"393","author":"MJ Roobol","year":"2025","unstructured":"Roobol MJ, de Vos II, M\u00e5nsson M et al (2025) European study of prostate cancer screening\u201423-year follow-up. N Engl J Med 393:1669\u20131680. https:\/\/doi.org\/10.1056\/nejmoa2503223","journal-title":"N Engl J Med"},{"key":"560_CR29","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9226","author":"JM Albert","year":"2013","unstructured":"Albert JM (2013) Radiation risk from CT: implications for cancer screening. Am J Roentgenol. https:\/\/doi.org\/10.2214\/AJR.12.9226","journal-title":"Am J Roentgenol"},{"key":"560_CR30","doi-asserted-by":"publisher","first-page":"3310","DOI":"10.1007\/s00330-015-4155-8","volume":"26","author":"SM Tao","year":"2016","unstructured":"Tao SM, Wichmann JL, Schoepf UJ et al (2016) Contrast-induced nephropathy in CT: incidence, risk factors and strategies for prevention. Eur Radiol 26:3310\u20133318","journal-title":"Eur Radiol"},{"key":"560_CR31","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.urology.2017.07.016","volume":"108","author":"K Koo","year":"2017","unstructured":"Koo K, Zubkoff L, Sirovich BE et al (2017) The burden of cystoscopic bladder cancer surveillance: anxiety, discomfort, and patient preferences for decision making. Urology 108:122\u2013128. https:\/\/doi.org\/10.1016\/j.urology.2017.07.016","journal-title":"Urology"},{"key":"560_CR32","doi-asserted-by":"publisher","first-page":"51","DOI":"10.25270\/jcp.2020.5.00001","volume":"6","author":"A Aly","year":"2020","unstructured":"Aly A, Johnson C, Doleh Y et al (2020) The real-world lifetime economic burden of urothelial carcinoma by stage at diagnosis. J Clin Pathways 6:51\u201360. https:\/\/doi.org\/10.25270\/jcp.2020.5.00001","journal-title":"J Clin Pathways"},{"key":"560_CR33","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1148\/rg.256045517","volume":"25","author":"RFJ Browne","year":"2005","unstructured":"Browne RFJ, Meehan CP, Colville J et al (2005) Transitional cell carcinoma of the upper urinary tract: spectrum of imaging findings. Radiographics 25:1609\u20131627. https:\/\/doi.org\/10.1148\/rg.256045517","journal-title":"Radiographics"},{"key":"560_CR34","doi-asserted-by":"publisher","first-page":"45","DOI":"10.3233\/BLC-160068","volume":"3","author":"RS Matulewicz","year":"2017","unstructured":"Matulewicz RS, DeLancey JO, Pavey E et al (2017) Dipstick urinalysis as a test for microhematuria and occult bladder cancer. Bladder Cancer 3:45\u201349. https:\/\/doi.org\/10.3233\/BLC-160068","journal-title":"Bladder Cancer"},{"key":"560_CR35","doi-asserted-by":"publisher","first-page":"1698","DOI":"10.1016\/j.juro.2010.12.093","volume":"185","author":"H Jung","year":"2011","unstructured":"Jung H, Gleason JM, Loo RK et al (2011) Association of hematuria on microscopic urinalysis and risk of urinary tract cancer. J Urol 185:1698\u20131703. https:\/\/doi.org\/10.1016\/j.juro.2010.12.093","journal-title":"J Urol"},{"key":"560_CR36","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.eururo.2019.10.010","volume":"77","author":"I Jubber","year":"2020","unstructured":"Jubber I, Shariat SF, Conroy S et al (2020) Non-visible haematuria for the detection of bladder, upper tract, and kidney cancer: an updated systematic review and meta-analysis. Eur Urol 77:583\u2013598. https:\/\/doi.org\/10.1016\/j.eururo.2019.10.010","journal-title":"Eur Urol"},{"key":"560_CR37","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/bju.14459","volume":"123","author":"WS Tan","year":"2019","unstructured":"Tan WS, Sarpong R, Khetrapal P et al (2019) Does urinary cytology have a role in haematuria investigations? BJU Int 123:74\u201381. https:\/\/doi.org\/10.1111\/bju.14459","journal-title":"BJU Int"},{"key":"560_CR38","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1111\/cyt.13458","volume":"36","author":"H Jangir","year":"2025","unstructured":"Jangir H, Narwal A, Adhikari SS et al (2025) Evaluation of diagnostic accuracy of the Paris system (TPS 2.0) in urine cytology specimens: an institutional experience from a large cohort of a tertiary care centre. Cytopathology 36:140\u2013149. https:\/\/doi.org\/10.1111\/cyt.13458","journal-title":"Cytopathology"},{"key":"560_CR39","doi-asserted-by":"publisher","DOI":"10.1002\/bco2.70093","author":"F Liedberg","year":"2025","unstructured":"Liedberg F, Hagberg O, H\u00e4ggstr\u00f6m C et al (2025) Waiting time in diagnosis and extirpative surgery and association with survival and stage progression in upper tract urothelial carcinomas. BJUI Compass. https:\/\/doi.org\/10.1002\/bco2.70093","journal-title":"BJUI Compass"},{"key":"560_CR40","doi-asserted-by":"publisher","first-page":"2173","DOI":"10.1002\/cncr.22224","volume":"107","author":"EM Messing","year":"2006","unstructured":"Messing EM, Madeb R, Young T et al (2006) Long-term outcome of hematuria home screening for bladder cancer in men. Cancer 107:2173\u20132179. https:\/\/doi.org\/10.1002\/cncr.22224","journal-title":"Cancer"},{"key":"560_CR41","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10654-010-9491-z","volume":"25","author":"A Stang","year":"2010","unstructured":"Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603\u2013605. https:\/\/doi.org\/10.1007\/s10654-010-9491-z","journal-title":"Eur J Epidemiol"}],"container-title":["Familial Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10689-026-00560-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10689-026-00560-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10689-026-00560-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T22:38:52Z","timestamp":1781649532000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10689-026-00560-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":41,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["560"],"URL":"https:\/\/doi.org\/10.1007\/s10689-026-00560-5","relation":{},"ISSN":["1573-7292"],"issn-type":[{"value":"1573-7292","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"assertion":[{"value":"19 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"45"}}