From Old Battles Won To New Frontiers In Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) is an autosomal dominant syndrome characterized by the development of numerous colorectal adenomas and a markedly increased risk of colorectal cancer (CRC).1,2 With the introduction of endoscopic surveillance and prophylactic colectomy in the latter part of the past century, the risk of developing CRC declined dramatically, shifting clinical attention toward duodenal cancer, which became the most common malignancy among patients with FAP under surveillance.3,4 Duodenal cancer in FAP is preceded by adenomas, and the increasing use of endoscopic resection in recent decades, combined with selective duodenal surgery when indicated, may have mitigated the risk of duodenal cancer—similar to what was previously observed for CRC.