Management of Familial Adenomatous Polyposis in Children and Adolescents: Position Paper From the ESPGHAN Polyposis Working Group.

Warren Hyer, Shlomi Cohen, Thomas Attard, Victor Vila-Miravet, Corina Pienar, Marcus Auth, Seth Septer, Jackie Hawkins, Carol Durno, Andrew Latchford

Journal: Journal of pediatric gastroenterology and nutrition 2020;68(3):428-441

PMID: 30585891

Abstract

Familial adenomatous polyposis (FAP) is a well-described inherited syndrome, characterized by the development of hundreds to thousands of adenomas in the colorectum, with implications in children and adolescents. Almost all adult patients will develop colorectal cancer if they are not identified and treated early enough. Identifying and screening for FAP commences in adolescence. The syndrome is inherited as an autosomal dominant trait and caused by mutations in the adenomatous polyposis (APC) gene. This European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) position paper provides a guide for diagnosis, assessment, and management of FAP in children and adolescents.This is the first position paper regarding FAP published by ESPGHAN. Literature from PubMed, Medline, and Embase was reviewed and in the absence of evidence, recommendations reflect the opinion of paediatric and adult experts involved in the care of polyposis syndromes. Because many of the studies that form the basis for the recommendations were descriptive and/or retrospective in nature, these of the recommendations are supported on expert opinion. This position paper will instruct on the appropriate management and timing of procedures in children and adolescents with FAP.

Address: St Mark's Hospital Polyposis Registry, Harrow, UK.; Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Children's Mercy Hospital, Kansas City, MO.; Sant Joan de Deu Hospital, Barcelona, Spain.; Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.; Alder Hey Children's NHS Foundation Trust, Liverpool, UK.; Children's Hospital of Colorado, Aurora, CO.; Department of Paediatrics, Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital and The Hospital for Sick Children, University of Toronto, Toronto, Canada.
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