UK guidelines for management of hereditary CRC

  • Monahan KJ & al.
  • Gut
  • 28 Nov 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Joint guidelines from the British Society of Gastroenterology, the Association of Coloproctology of Great Britain and Ireland, and the United Kingdom Cancer Genetics Group define risk categories and cover a wide range of conditions.

Why this matters

  • Updates 2010 guidelines, but focuses on those with heightened lifetime risk because of hereditary factors.

Key points

  • Risk categories:
    • Average risk: no family history of colorectal cancer (FHCC) or a FHCC that does not match the moderate- or high-risk categories.
    • Moderate risk: FHCC with 1 first-degree relative (FDR) diagnosed at age
    • High risk: ≥3 FDRs with CRC at any age spread across ≥2 generations. The individual must be an FDR to at least 1 individual.
  • Key recommendations cover: service provision, communication, and management; managing individuals with a family history of CRC, including preventive strategies and lifestyle modifications; and advanced endoscopic imaging in colonic surveillance.
  • Testing and management recommendations for individual syndromes, including Lynch syndrome, Lynch-like syndrome, early-onset CRC, serrated polyposis syndrome, patients with multiple colorectal adenomas, familial adenomatous polyposis, MUTYH-associated polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome.