The risk of malignization incidence in patients with polyps and polyposis of the colon and rectum

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Inherited Adenomatous Polyposis Syndromes

“…According to observational data, colorectal cancer has not been reported before the age of 9 years in patients with FAP, and data pooled from 5 European polyposis registries found that only 0.2% of patients developed cancer before the age of 15 years and 1.3% developed cancer before the age of 20 years. [32][33][34][35] Screening strategies rely on 2 features of FAP. The first is that the rectum is almost always affected in classic FAP and the second is that the progression from polyp to cancer is not accelerated despite polyp formation at a young age.…”

“…1,31,32,[43][44][45] Population-based data from 4 European centers evaluating 776 patients who underwent IRA (576 from the pre-IPAA era) found that the cumulative risk of rectal cancer was 10% in the pre-IPAA era versus 2% in the IPAA era. 33 In terms of rectal polyp burden influencing the risk of subsequent rectal cancer, a cohort study of 213 patients with FAP found that the incidence of rectal cancer was 1.6% in patients with fewer than 20 rectal polyps (n = 128) compared to 10.8% in patients with more than 20 rectal polyps (n = 37). 46 A cohort study from the Singapore Polyposis Registry examined 122 patients with FAP from 88 families over 20 years and reported that cancer recurrence and disease-free survival was not different with selective use of IRA (relative paucity of rectal polyps during original operation) after 98 months of follow-up.…”

“…According to observational data, colorectal cancer has not been reported before the age of 9 years in patients with FAP, and data pooled from 5 European polyposis registries found that only 0.2% of patients developed cancer before the age of 15 years and 1.3% developed cancer before the age of 20 years. 32–35…”