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Patients with a Family History of Colorectal Carcinoma

 

HIGH RISK

Immediate referral to GI services at any age if at risk of

  • Hereditary Non-Polyposis Colon Cancer (HNPCC aka Lynch syndrome)
    • Cancer of the colon/ endometrium/ ovary/ stomach/ upper urothelial tract/ biliary tree in:
      • 3 or more FDRs with
      • 2 generations involved and
      • 1 cancer diagnosed below age 50
  • Familial Admomatous Polyposis (FAP)
    • First degree relative with Familial Adenomatous Polyposis or any other genetic colorectal cancer condition

 

MODERATE – LOW RISK

Refer these patients to GI services asap at or over the age of 50 (they will probably be offered a colonoscopy)

  • CRC in 3 FDR none age < 50 (if any aged < 50 see high risk above)
  • CRC in 2 FDRs at any age
  • CRC in one FDR age < 50

 

NOTE – PLEASE REFER ALL PATIENTS FITTING ANY OF THESE CRITERIA TO THE CLINICAL GENETICS DEPARTMENT AS WELL AS THE GI SERVICES

 

Glossary

FDRs = first degree relatives

CRC = colorectal cancer

 

Reference

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002) Gut 2010;59:666e690. doi:10.1136/gut.2009.179804

Personal communication with Dr C Brewer, Consultant, Peninsula Clinical Genetics Service May 2012