[Colorectal cancer in familial adenomatous polyposis: Are there clinical predictive factors?].
BACKGROUND
Familial Adenomatous Polyposis (FAP) is a hereditary disorder with multiple colorectal polyps that exhibit an almost inevitable risk of colorectal cancer (CRC) in untreated patients.


OBJECTIVE
To evaluate clinical features related to CRC risk at diagnosis.


METHODS
Charts from 88 patients were reviewed to collect information regarding age, family history, symptoms, polyposis severity and association with CRC.


RESULTS
41 men (46.6%) and 47 women (53.4%) were assisted. CRC was detected in 53 patients (60.2%), with a frequency of 9.1% under 20 years, 58% between 21-40 and 85% over 41 years of age. Average age of patients without CRC was lower at treatment (29.5 vs. 40.0 years; p=0.001). Family history was reported by 58 patients (65.9%), whose average age did not differ from those who didn't report it (33.4 vs. 34.4; p=0.17). Asymptomatic patients comprised 10.2% of the total; in this group, CRC incidence was much lower when compared to those presenting symptoms (1.1% vs. 65.8%; p=0.001). Patients without CRC presented a shorter length of symptoms (15.2 vs. 26.4 months; p=0.03) and less frequent weight loss (11.4% vs. 33.9%; p=0.01). At colonoscopy, polyposis was classified as attenuated in 12 patients (14.3%), who presented greater average age (48.2 vs. 33.3 years; p=0.02) and equal CRC incidence (58.3% vs. 58.3%; p=0.6) when compared to those with classic polyposis.


CONCLUSIONS
The risk of CRC in FAP patients 1) increases significantly after the second decade; 2) is associated with higher age, weight loss, presence and duration of simptomatology; 3) is similar in patients with attenuated or classic phenotype.
Departamento de Gastroenterología, Hospital das Clínicas, Universidad de São Paulo, Brasil. fgmcampos@terra.com.br
Fábio Guilherme C M
FG
de Campos
Isabella
I
Nicácio De Freitas
Antônio Rocco
AR
Imperiale
Víctor Edmond
VE
Seid
Rodrigo Oliva
RO
Perez
Sérgio Carlos
SC
Nahas
Ivan
I
Cecconello
D011125:Adenomatous Polyposis Coli / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult