Upper GI polyposis and cancer in FAP: diagnosis, surveillance and treatment.

Yoji Takeuchi, Sonia S Kupfer, Evelien Dekker, Carol A Burke, Gautam Mankaney, Yusaku Shimamoto, Arthur S Aelvoet

Journal: Familial cancer 2025;24(2):49

PMID: 40418521

Abstract

Colorectal cancer can be prevented in most patients with FAP by performing (procto)colectomy and lifelong endoscopic surveillance. Subsequently, the challenge is to prevent duodenal and gastric cancer. Duodenal cancer is one of the most common FAP-related causes of death and, in the last decade, the incidence of gastric cancer has increased. Performing frequent endoscopic surveillance with removal of neoplasia is important to prevent cancer especially since cancers in the upper GI tract generally have a poor prognosis. Moreover, the goal is to prevent upper GI surgery as these procedures are associated with substantial morbidity. In this review, we provide the prevalence of upper GI polyposis and cancer, describe endoscopic and histologic features, and discuss strategies for surveillance and treatment.

Address: Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands.; Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.; Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.; Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.; Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.; Department of Genetic Oncology, Division of Hereditary Tumors, Osaka International Cancer Institute, Osaka, Japan.; Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.; Sanford R Weiss MD Center for Hereditary Colorectal Neoplasia, Cleveland Clinic, Cleveland, OH, USA.; Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH, USA.; Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago, Chicago, IL, USA.; Department of Gastroenterology and Hepatology, Virginia Mason Franciscan Health Hospital, Seattle, WA, USA. [email protected].

DOI: 10.1007/s10689-025-00472-w

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Full Text Sources:

https://doi.org/10.1007/s10689-025-00472-w

MeSH Terms: Humans, Adenomatous Polyposis Coli, Stomach Neoplasms, Duodenal Neoplasms, Early Detection of Cancer