Which statement about Familial Adenomatous Polyposis is most accurate?

Which statement about Familial Adenomatous Polyposis is most accurate?

• A. Annual colonoscopies begin at age 40
• B. Cancer risk is low
• C. Surveillance not necessary
• D. Prophylactic colectomy improves survival

Answer: (D)

Familial Adenomatous Polyposis is a condition where many polyps develop in the colon due to an APC gene mutation, and virtually all patients will develop colorectal cancer if the colon is not removed. The key management goal is to prevent cancer by removing the tissue where polyps form, which is why prophylactic colectomy is recommended. By taking out the colon before cancer can develop, survival is markedly improved compared with waiting for cancer to appear. After colectomy, some cancer risk remains in residual rectal tissue or in a reconstructed pouch, so continued surveillance of any remaining mucosa is still important, but the overall cancer risk is greatly reduced. Surveillance guidelines do not start at age 40; they begin in adolescence because polyps can begin forming early in life. Statements claiming cancer risk is low or that surveillance is unnecessary are incorrect. The most accurate statement is that prophylactic colectomy improves survival by removing the organ at highest risk for malignant transformation.

Familial Adenomatous Polyposis is a condition where many polyps develop in the colon due to an APC gene mutation, and virtually all patients will develop colorectal cancer if the colon is not removed. The key management goal is to prevent cancer by removing the tissue where polyps form, which is why prophylactic colectomy is recommended. By taking out the colon before cancer can develop, survival is markedly improved compared with waiting for cancer to appear. After colectomy, some cancer risk remains in residual rectal tissue or in a reconstructed pouch, so continued surveillance of any remaining mucosa is still important, but the overall cancer risk is greatly reduced. Surveillance guidelines do not start at age 40; they begin in adolescence because polyps can begin forming early in life. Statements claiming cancer risk is low or that surveillance is unnecessary are incorrect. The most accurate statement is that prophylactic colectomy improves survival by removing the organ at highest risk for malignant transformation.