Those at higher risk for colon cancer due to bowel disorders or a family history of the disease should be screened more often and earlier. CRC runs in some families, but there is not always an identified genetic mutation associated with the transmission of the disease. On the other hand, several forms of familial colorectal cancer are associated with specific mutations. These diseases tend to occur at an earlier age. There are several syndromes that fall under this category. For example, familial adenomatous polyposis (FAP) causes the formation of numerous colonic polyps, often numbering in the hundreds. Any of these polyps has the potential to become cancerous. Because of the extreme risk of cancer with this syndrome, patients with a family history of the disease should begin screening at adolesence. Preventative surgery may be performed to prevent cancer formation.
Hereditary Non-Polyposis Colorectal Cancer (HNPCC) is another inherited condition that places individuals at high risk for colon cancer. This syndrome results in the formation of only a few polyps, but they occur at a very young age. It is suggested that people diagnosed with this syndrome be screened every 1-2 years starting at the age of 25 or 10 years prior to the youngest CRC diagnosis in their family. Other syndromes with an increased risk in developing CRC are Peutz-Jeghers syndrome, Juvenile Polyposis, and Cowden syndrome. Testing for these syndromes can have financial and psychological implications. Consultation with a genetic counselor provides patients with their available options.(1)
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