Volume 8 Supplement 1

Proceedings of the 13th Annual Meeting of the Collaborative Group of the Americas on Inherited Colorectal Cancer

Open Access

High risk clinic for hereditary colorectal neoplasia: a focus for patient care and an opportunity for clinical research

  • Lisa LaGuardia1Email author,
  • Margaret O'Malley1,
  • Jon D Vogel1,
  • Brandie Leach1,
  • Carol Burke1,
  • Matthew Kalady1 and
  • James Church1
Hereditary Cancer in Clinical Practice20108(Suppl 1):P10

https://doi.org/10.1186/1897-4287-8-S1-P10

Published: 25 May 2010

Background

Patients with hereditary colorectal neoplasia and their families need specialized care to plan for appropriate surveillance and to ensure that they receive the most favorable treatment. This involves coordinating multidisciplinary appointments on the same day to minimize inconvenience to patients. We have established a special high risk clinic for these patients and their families. In this study we are reporting our activity for the last 5 years.

Methods

Initially the clinic ran one morning a month but has grown in the last 2 years adding another half day session. Requests for appointments were triaged by registry coordinators. Patients with syndromes of hereditary colorectal neoplasia were eligible for this clinic if the necessary appointments included multiple physicians. The clinic is staffed by one of three colorectal surgeons, one gastroenterologist, one genetic counselor, one hepatobiliary/upper GI surgeon and often by a clinical geneticist.

Results

From January 2004 to November 2008 there have been 440 patient visits (Table 1), 68 colonoscopies, 180 flexible sigmoidoscopies, and 226 EGDs (Table 2), 44 consults to medical genetics were performed, and 9 to general surgery (Table 3). Clinic activity generated 101 surgeries including 37 colectomies and 7 duodenectomies. If all the appointments were done separately this would mean at least 967 separate visits.

Table 1

Patients seen by syndrome

2004

2005

2006

2007

2008

FAP

41

63

85

92

101

MYH

0

1

3

1

2

JPS

5

4

0

3

5

PJS

1

0

1

0

0

HPS

0

0

1

1

4

HNPCC

0

0

4

6

2

Other

2

5

2

1

4

Total

49

73

96

104

118

Table 2

Procedures

2004

2005

2006

2007

2008

C-scope

9

11

24

12

12

UGI

26

46

41

45

48

Capsule

0

2

1

0

2

Sigmoidoscopy

13

40

45

49

43

Surgery

5

8

16

31

41

Table 3

Referrals

2004

2005

2006

2007

2008

Medical Genetics

4

11

1

20

18

Thyroid Consult

0

0

0

0

4

General Surgery

2

2

5

0

0

Conclusion

The High Risk Clinic is a valuable resource for patients, insurers, and registry workers.

Authors’ Affiliations

(1)
The Sanford R. Weiss, M.D. Center for Hereditary Colorectal Neoplasia, Digestive Disease Institute, Cleveland Clinic

Copyright

© LaGuardia et al; licensee BioMed Central Ltd. 2010

This article is published under license to BioMed Central Ltd.

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