Mutations associated with adenomatous polyposis syndromes significantly
increase the probability of developing cancer. If COLARIS AP® test
results for a patient show an increased risk for cancer, the following medical
management options can help reduce that risk, and either prevent or detect
cancer at an early, treatable stage.
|
|
 |
|
FAP |
Increased Surveillance
 |
|
 |
Annual flexible sigmoidoscopy beginning between ages 10-12.24 |
|
Following a prophylactic subtotal colectomy, flexible sigmoidoscopy
of remaining ileal pouch and rectal epithelium every six months to three
years, depending on the number of polyps found on previous exam .31,
41 |
|
Esophagogastroduodenoscopy (EGD) every 1-4 years (depending on polyp burden)
beginning between ages 20-25.52 |
|
Annual physical examination including palpation of the thyroid, beginning
between ages 10-12.52 |
|
|
|
| Chemoprevention |
|
|
Currently research is being done to determine the effectiveness of NSAIDS
in colorectal polyp development. The FDA has approved some NSAIDS to help prevent
polyps from forming after a total colectomy (in the rectum) but none of these
drugs have been proven to reduce or prevent polyp formation prior to surgery.54 |
|
|
|
| Surgical Options |
|
|
Prophylactic total colectomy is advised following the development
of adenomatous polyps.54 |
|
|
| **Note: Screening for other FAP/AFAP-associated cancers (brain,
pancreatic, hepatoblastoma, etc.) may be considered depending on the
family history. |
| |
| AFAP |
|
| Increased Surveillance |
|
|
Colonoscopy every one to three years beginning in the late teens
or mid-twenties.53 |
|
Esophagogastroduodenoscopy (EGD) every 1-4 years (depending on polyp
burden) beginning between ages 20-25.52 |
|
|
|
| Surgical Options |
|
|
Prophylactic colectomy may not be necessary for a person diagnosed
with an APC,
though it should be considered on an individual basis.24 |
|
|
| **Note: Screening for other FAP/AFAP-associated cancers (brain,
pancreatic, hepatoblastoma, etc.) may be considered depending on the family
history. |
| |
| MAP |
|
|
|
Unique screening recommendations for MAP have not yet been
established. It is recommended that patients with MAP follow
screening guidelines for FAP or AFAP, depending on the individual
polyp burden.56 |
|
|
Screening Recommendations
for
Extracolonic Manifestations of FAP and AFAP
| Cancer Type |
Begin |
Method |
Interval |
| Duodenal and Gastric cancer |
20-25 |
EGD |
every
1-4 years |
| Thyroid cancer |
10-12 |
physical
exam |
annual |
| Hepatoblastoma |
birth to
age 5 |
serum AFP, imaging |
annual |
» Benefits of COLARIS AP® Testing
A genetic test for adenomatous polyposis syndromes
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