Colon Cancer Update Review

Certain groups of patients have a predisposition to the development of cancer of the large bowel. These identifiable high-risk cohorts also have a greater possibility for early intervention and cancer prevention and include patients with inherited conditions such as familial adenomatous polyposis (FAP), hereditary nonpolyposis colon cancer (HNPCC), and ulcerative colitis. Patients with FAP (frequency estimated at 1:7,000 to 10,000 live births) have a lifetime risk of the development of colon cancer that approaches 100%. The disease is inherited as an autosomal dominant trait, and affected individuals will transmit this predisposition, with each of their offspring having nearly a 50% chance of developing polyposis coli. The gene that causes FAP (adenomatous polyposis coli [APC] gene) resides on chromosome 5 and has been cloned and sequenced.