Hereditary Nonpolyposis Colorectal Cancer Surveillance

Last Modified: April 18, 2003

Dear OncoLink "Ask The Experts,"
I was successfully treated at the age of 39, for uterine cancer. My father was successfully treated, at age 62 for non-polyps colon cancer. His mother was successfully treated for non-polyps colon cancer. Having had uterine cancer and coming from a family line of colorectal cancers, what are my risks of developing a related colorectal cancer in the future?

Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:

Your history and your family history suggest he possibility that you could have the inherited syndrome Hereditary Nonpolyposis Colorectal Cancer or HNPCC. Generally, the criteria stipulate that three members of the family have colon cancer, but as uterine cancer is one of the associated cancers, it can be substituted. Genetic testing, looking for a mutation in one of the genes responsible for HNPCC may give the answer, if it is found, but its absence does not rule out the possibility that your family could have the disease. If you do have it, your risk for colon cancer at some point would be very high, if you don't get frequent surveillance. Patients with HNPCC have as much as an 80% chance of getting colon cancer. If this were not an HNPCC family, your risk would be on the order of a 3-fold increase or 15 to 20% lifetime risk. On their face value, those numbers look very frightening, but frequent surveillance colonoscopies have been shown to be very effective in reducing that risk. I would suggest that you contact a center that can evaluate your family history carefully, possibly offer genetic counseling and testing and give you appropriate recommendations for surveillance colonoscopies. OncoLink has joined forces with the National Colorectal Research Alliance to help their scientists study the risk factors associated with colorectal cancer and identify potential preventive and treatment therapies. You and your family may be interested in taking our survey. This confidential survey was developed by cancer experts as an interactive way to help our leading scientists study families with a history of colorectal cancer. OncoLink/National Colorectal Cancer Research Alliance prevention database.