Surveillance in Hereditary Nonpolyposis Colorectal Cancer

Abstract

Colorectal cancer surveillance based on a positive family history is gaining widespread acceptance. Because subjects with a positive family history are a heterogeneous group, critical assessment of the history should be made so that a clinical likelihood of hereditary nonpolyposis colorectal cancer (HNPCC) can be established. Findings from surveillance of asymptomatic subjects with HNPCC, and more modest family histories, are contrasted in this article. The threshold for colonoscopic surveillance should be low in subjects with any immediate family history of early-onset colorectal cancer, and in subjects with multiple relatives affected at any age.