Colorectal Adenoma Canceration in FAP

The current internationally accepted treatment method for familial adenomatous polyposis is prophylactic total colorectal resection combined with endoscopic follow-up. However, total colorectal resection will bring a sharp decline in the quality of life of patients. Therefore, how to improve treatment methods and improve the quality of life for such patients under the premise of medical quality is the current medical focus. This study intends to establish three parallel observation cohorts, namely the surgical treatment group, the intensive colonoscopy treatment group, and the autonomous monitoring group. During the three-year study period, the investigators observed changes in the number of adenomas, carcinogenesis, and medical expenses in each group during the 3-year study period, and compared the groups to determine whether the intensive colonoscopy therapy has the possibility of delaying or replacing preventive surgery.

Sex

All

Minimum age

18 Years

Maximum age

40 Years

Inclusion Criteria:

* The initial number of polyps is between 100-1000 visually;
* Pathological diagnosis of multiple lesions confirmed colorectal adenoma;
* Germline mutation detection is clearly a point mutation or large deletion of APC gene;
* No cancer or distant metastasis.

Exclusion Criteria:

* Age \<18, or \>40 years old;
* The initial number of polyps is \<100, or \>1000;
* The polyp has become cancerous or has suspected distant metastasis;
* Patients with intestinal obstruction, intestinal perforation, intestinal bleeding and other patients who need emergency surgical resection;
* Past history of colorectal surgery;
* Suffering from malignant tumors in other parts and requiring treatment or using chemotherapy drugs or NSAIDs;
* The patient has contraindications to colonoscopy;
* Patients or family members cannot understand the conditions and goals of this study;
* The patient plans to receive surgical treatment of preventive colorectal resection;
* Other reasons considered by the study doctor to be inappropriate for inclusion in the study.

• BACKGROUNDKarstensen JG, Burisch J, Pommergaard HC, Aalling L, Hojen H, Jespersen N, Schmidt PN, Bulow S. Colorectal Cancer in Individuals With Familial Adenomatous Polyposis, Based on Analysis of the Danish Polyposis Registry. Clin Gastroenterol Hepatol. 2019 Oct;17(11):2294-2300.e1. doi: 10.1016/j.cgh.2019.02.008. Epub 2019 Feb 8. PMID 30743005
• BACKGROUNDBulow S. Results of national registration of familial adenomatous polyposis. Gut. 2003 May;52(5):742-6. doi: 10.1136/gut.52.5.742. PMID 12692062