General Familial Adenomatous Polyposis Cancer Risks in Danish National Registries
Douglas K. Rex, MD, MASGE, reviewing Karstensen JG, et al. Gastroenterology 2023 May 16.
Cancer incidence studies in national registries, such as that maintained in Denmark, are of interest because they reduce referral bias.
A study used nationwide Danish registries to evaluate data, dating back to 1974, on 565 patients with familial adenomatous polyposis (FAP) and 1890 controls. Overall cancer risk was increased with FAP (hazard ratio [HR], 4.12), with risk highest for colorectal cancer (HR, 4.61), duodenal/small bowel cancer (HR, 14.49), and pancreatic cancer (HR, 6.45). There was no detectable increase in gastric, liver, or thyroid cancer. The registry does not include data on desmoids.
COMMENTThe National Comprehensive Cancer Network guidelines recommend surveillance in FAP for gastric and thyroid cancer but not for pancreatic cancer. It’s not clear that the absolute risk increase would warrant pancreatic cancer screening in patients with FAP, or if it did, at what age it should begin. More data of this type are needed to define whether screening for pancreatic cancer in patients with FAP is warranted.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Karstensen JG, Bülow S, Højen H, et al. Cancer in patients with familial adenomatous polyposis – a nationwide Danish cohort study with matched controls. Gastroenterology 2023 May 16. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2023.05.010)
