Inherited colorectal cancer: A plea for a national registry

Abstract

Colorectal cancer (CRC) is the third most common cancer and cause of cancer-related death worldwide. Inherited CRCs may constitute a significant portion of the total disease burden of CRC in South Africa, and hence represent a target for focused screening and surveillance. There are few, if any, hereditary cancer registries in southern Africa and the African continent like the Lynch syndrome registry from the Western and Northern Cape, which provided the impetus for the Vergouwe study reported on in the February SAJS. One way to start such a registry is to identify patients at risk by using the inexpensive immunohistochemistry technique used by Vergouwe et al., which detects absence of the hMLH1 gene product on all resected colorectal cancers. Those identified should undergo genetic counselling, and targeted screening of the appropriate family members should be offered. There is a need for colorectal surgeons and their association to establish such a registry and to implement focused surveillance programmes, which ultimately will save lives.