Table 1

Cancer screening recommendations for those with a family history suggestive of a hereditary colorectal cancer syndrome

Syndrome	Cancer surveillance	Screening recommendations	Considered “appropriate” surveillance (for the purpose of this study)
If polyps are found, assessment of indications for colectomy. If genetic testing is performed and APC* gene mutation (−), flexible sigmoidoscopy at age 25.^3,^7,¹⁰
HNPCC	Colorectal	Colonoscopy every 1–2 years beginning at age 25	Colonoscopy every 1–3 years beginning at age 25
	Endometrial (women only)	Transvaginal ultrasound ± endometrial biopsy every 1 year beginning at age 25–35	Endometrial ultrasound or biopsy every year beginning at age 35
FAP
People without polyps	Colorectal	Flexible sigmoidoscopy* every 1 year beginning at age 12	Flexible sigmoidoscopy or colonoscopy every 1–3 years
		Flexible sigmoidoscopy*
		Every 1 years, ages 12–25
		Every 2 years, ages 26–35
		Every 3 years, ages 36–50
		After age 50 resume “average risk” screening
People with polyps	Upper tract	Upper endoscopy with ampullary biopsy every 6 months to 4 years depending on polyp burden	EGD every 1–5 years
	Colorectal	Surgical colectomy with continued upper and lower tract surveillance
Subtotal colectomy or total colectomy with ileorectal anastomosis	Rectal remnant	Flexible sigmoidoscopy every 6 months–1 year with polypectomies as needed	Flexible sigmoidoscopy every 1 year
Total colectomy with ileoanal anastomosis	Pouch	Endoscopic surveillance of pouch every 3–5 years (increase frequency if polyps are found)	Flexible sigmoidoscopy every 3–5 years