title: Screening for thyroid cancer in patients with familial adenomatous polyposis.
abstract: OBJECTIVE
  Clarify the incidence of thyroid cancer in patients with Familial adenomatous polyposis (FAP) in a prospective study of thyroid neck US screening.
  
  
  BACKGROUND
  FAP is a hereditary disease predisposing to cancer in multiple organs, including the thyroid. However, routine thyroid screening for FAP patients is not generally practiced in the United States. Here, we report the initial results of a prospective thyroid cancer screening program in patients with FAP.
  
  
  METHODS
  At the time of yearly gastrointestinal follow-up, every FAP patient in our registry was offered thyroid ultrasound (US) performed by experienced endocrine surgeons. Clinical findings related to thyroid disease were analyzed for those patients who completed screening from August 2008 to December 2009.
  
  
  RESULTS
  : Of 192 screened FAP patients, 72 (38%) had thyroid nodules and 5 (2.6%) had thyroid cancer. Three of 5 patients with FAP and thyroid cancer were women. Four of 5 patients had the multifocal papillary type with mean size 15 mm. Clinical history and neck exam did not detect any of the 5 cancers.
  
  
  CONCLUSIONS
  The incidence of thyroid cancer among FAP patients is high. Medical history and exam are inadequate to identify patients with thyroid cancer, thus thyroid screening with US is warranted.
authors.affiliation: Department of Colorectal Surgery,Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Awad M
authors.initials: AM
authors.lastname: Jarrar
authors.forename: Mira
authors.initials: M
authors.lastname: Milas
authors.forename: Jamie
authors.initials: J
authors.lastname: Mitchell
authors.forename: Lisa
authors.initials: L
authors.lastname: Laguardia
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Malley
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
authors.forename: Allan
authors.initials: A
authors.lastname: Siperstein
authors.forename: Carol
authors.initials: C
authors.lastname: Burke
authors.forename: James M
authors.initials: JM
authors.lastname: Church
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D011125:Adenomatous Polyposis Coli / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003113:Colonoscopy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D009820:Ohio; D011446:Prospective Studies; D012042:Registries; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000235:genetics*; D014463:Ultrasonography; D055815:Young Adult