Descriptive review and comparison of clinical outcomes of AFAP patients
© McCoy et al; licensee BioMed Central Ltd. 2011
Published: 10 March 2011
This study aimed to examine the colonic polyp phenotype, the surgical outcomes, and the reasons for colectomy in individuals with Attenuated Familial Adenomatous Polyposis (AFAP).
Colonoscopy and colectomy medical records were obtained for 197 individuals with a known genetic mutation in the region of the APC gene causative of AFAP.
Colectomy appears to becoming more common in patients with AFAP and is being recommended at younger ages. A greater number of colectomies were performed in the 1990s which coincided with the identification of the APC gene mutation in this family. Subtotal colectomy with ileorectal anastomosis (IRA) is the most common type of colectomy, though 23% still had proctocolectomies with ileoanal anastomosis. Cancer risk did not necessarily correlate with polyp number as 7 individuals with fewer than 20 polyps developed cancer. In the end several factors should be considered in developing a management plan for individuals with AFAP, including lifestyle, polyp number, comorbidities, adherence to screening and patient attitudes.
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