Hereditary genetic defects (inherited polyp syndromes) increase the
risk for developing
colorectal cancer. Two syndromes that increase the
risk for colon polyps and colorectal cancer are familial adenomatous polyposis
(FAP) and hereditary nonpolyposis colon cancer (HNPCC).
Familial adenomatous polyposis (FAP)
People who have FAP have a genetic abnormality called the APC gene
mutation.
FAP causes the early development of adenomatous polyps. People with
this syndrome develop polyps in their 20s and 30s or even earlier, have
hundreds to thousands of polyps throughout the colon by their 30s, and have an
almost 100% chance of developing colorectal cancer. People with this condition
can be identified with a genetic screening blood test. If positive, immediate
family members should be screened. Yearly screening with
sigmoidoscopy beginning at age 10 or 12 is
recommended.1 After polyps are detected, surgery to
remove the colon (colectomy) should be done to prevent cancer from developing.
Hereditary nonpolyposis colon cancer (HNPCC)
People who have hereditary nonpolyposis colon cancer (HNPCC) may
develop colon polyps at an early age. Experts recommend that people with HNPCC
have a colonoscopy every 1 to 2 years starting at age 20 to 25, or 10 years
younger than the age at which the youngest family member who has colorectal
cancer was diagnosed, whichever comes first. HNPCC is also sometimes known as
Lynch syndrome.1