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The Singapore Polyposis Registry.

H S Goh1, J Wong

  • 1Department of Colorectal Surgery, Singapore General Hospital.

Annals of the Academy of Medicine, Singapore
|March 1, 1992
PubMed
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The Singapore Polyposis Registry aids in identifying and managing individuals at high risk for colorectal cancer due to Familial Adenomatous Polyposis and Hereditary Non-polyposis Colorectal Cancer. Early screening significantly reduces cancer risk and mortality.

Area of Science:

  • Oncology
  • Genetics
  • Public Health

Background:

  • The Singapore Polyposis Registry was established in 1989 to centralize the identification, surveillance, and management of individuals and families at high risk for colorectal cancer.
  • Familial Adenomatous Polyposis (FAP) and Hereditary Non-polyposis Colorectal Cancer (HNPCC) are autosomal dominant conditions that can lead to early-onset colorectal cancer if untreated, accounting for 5-6% of all cases.

Purpose of the Study:

  • To provide a central registry service for doctors in Singapore.
  • To facilitate the identification, surveillance, and management of high-risk individuals and families for FAP and HNPCC.
  • To leverage advances in molecular genetics for improved diagnosis and management.

Main Methods:

  • Evaluation of 16 FAP families (139 members) and 8 HNPCC families (206 members).

Related Experiment Videos

  • Screening of at-risk individuals for FAP and HNPCC.
  • Initiation of colonoscopic surveillance for registered HNPCC patients.
  • Utilizing genetic testing for FAP diagnosis through APC gene identification.

    • Main Results:

    • In FAP families, 58 members were affected and 81 were at-risk/unaffected. Screened individuals had a 13% cancer risk versus 89% for those presenting with disease; mortality was nil versus 58% respectively.
    • In HNPCC, surveillance identified one case of early-stage cancer (Dukes' A) in a 26-year-old and two cases with polyps.
    • Genetic diagnosis of FAP is now possible through APC gene identification.

    Conclusions:

    • The Singapore Polyposis Registry plays a crucial role in managing hereditary colorectal cancer syndromes.
    • Early detection and surveillance through the registry significantly reduce cancer risk and mortality.
    • Molecular genetic advances, particularly APC gene identification, enhance FAP diagnosis and inform management strategies including prenatal diagnosis and chemoprevention.