title: Association between the age and the development of colorectal cancer in patients with familial adenomatous polyposis: a multi-institutional study.
abstract: OBJECTIVE
  To investigate the incidence of colorectal cancer among familial adenomatous polyposis (FAP) patients by phenotype using the latest modalities.
  
  
  METHODS
  We collected data on 303 patients who underwent surgery for FAP at one of 23 institutions between 2000 and 2012. The incidence of colorectal cancer was investigated by phenotype.
  
  
  RESULTS
  Colorectal cancer was diagnosed in 115 (38.0 %) of the 303 patients. Overall, colorectal cancer with the attenuated, sparse, and profuse phenotypes was diagnosed at 30, 31, and 28 years of age, respectively, in 10 % of the patients and at 59, 48, and 41 years of age, respectively, in 50 % of the patients (P = 0.013). The patients with colorectal cancer were older than those without colorectal cancer for all phenotypes. The optimal cut-off age for predicting the development of colorectal cancer in the attenuated, sparse, and profuse phenotypes was 46, 31, and 27 years, respectively.
  
  
  CONCLUSIONS
  Patients with profuse and sparse phenotypes should undergo prophylactic proctocolectomy before their mid-to-late 20 s. On the other hand, the timing and type of surgery for patients with attenuated FAP (AFAP) should be decided individually with reference to the colonoscopic findings.
authors: Department of Surgery, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan. h-kobayashi.srg2@tmd.ac.jp.|Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan. h-kobayashi.srg2@tmd.ac.jp.
authors: Hirotoshi
authors: H
authors: Kobayashi
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors: Hideyuki
authors: H
authors: Ishida
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgery, National Defense Medical College, Saitama, Japan.
authors: Hideki
authors: H
authors: Ueno
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgery and Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan.
authors: Takao
authors: T
authors: Hinoi
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors: Yasuhiro
authors: Y
authors: Inoue
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
authors: Fumio
authors: F
authors: Ishida
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Yukihide
authors: Y
authors: Kanemitsu
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors: Tsuyoshi
authors: T
authors: Konishi
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
authors: Tatsuro
authors: T
authors: Yamaguchi
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
authors: Naohiro
authors: N
authors: Tomita
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
authors: Nagahide
authors: N
authors: Matsubara
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Toshiaki
authors: T
authors: Watanabe
authors: Study Group for Familial Adenomatous Polyposis (FAP) in the Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.|Tokyo Medical and Dental University, Tokyo, Japan.
authors: Kenichi
authors: K
authors: Sugihara
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000150:complications* / Q000453:epidemiology* / Q000235:genetics / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D003082:Colectomy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D055815:Young Adult
keywords: Cancer development; Familial adenomatous polyposis; Phenotype