Familial adenomatous polyposis: complex patient management

Area of Science:

• Gastroenterology
• Oncology
• Hereditary Cancer Syndromes

Background:

• Familial adenomatous polyposis (FAP) is an inherited disorder characterized by numerous colorectal adenomas.
• FAP significantly increases the risk of colorectal cancer and other extracolonic tumors, including duodenal cancer and desmoid tumors.

Purpose of the Study:

• To highlight the importance of screening and surveillance in reducing colorectal cancer incidence and mortality in FAP patients.
• To discuss current diagnostic and therapeutic strategies for managing FAP.

Main Methods:

• Review of current international guidelines and literature on FAP management.
• Emphasis on endoscopic surveillance (colonoscopy, esophagogastroduodenoscopy) and surgical intervention (colectomy).
• Inclusion of newer tools for severity classification and individualized patient management.

Main Results:

• Screening and surveillance programs effectively reduce colorectal cancer incidence and mortality in FAP patients.
• Endoscopic therapy plays a crucial role in managing both upper and lower gastrointestinal manifestations.
• Individualized patient management based on updated guidelines and classification tools improves outcomes.

Conclusions:

• Effective management of FAP relies on rigorous screening, surveillance, and timely therapeutic interventions.
• Adherence to international guidelines and utilization of advanced classification tools are key to reducing FAP-related mortality.
• A multidisciplinary approach integrating endoscopic and surgical strategies is essential for optimal FAP patient care.