Familial Adenomatous Polyposis (FAP)

Classic FAP with its carpeting of adenomatous polyps throughout the colon and rectum is an easily recognizable phenotype and should prompt clinicians to initiate confirmatory genetic testing. More challenging would be the recognition of attenuated FAP or MYH-associated Polyposis which has a less florid polyposis phenotype. The workgroup felt that an addendum to existing guidelines should be made to highlight that the number of adenomas (10-100) that would trigger consideration for attenuated FAP or MYH-associated Polyposis refers to the cumulative incidence of adenomas over a patients lifetime.