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So we know that there are very specific hereditary syndromes related to risks of colon cancer.
Those are typically familial adenomatous polyposis or FAP. Now these are patients that early
on at adolescence develop 100 and 1000s of polyps and these are readily detected and
this drives the decision to then visit with a genetic counsellor who looks for the specific
genes can be mutated.
The second common hereditary syndrome is hereditary nonpolyposis colorectal cancer or HNPCC or
Lynch syndrome. Now this is a cancer that is not associated with polyps. The patients
unfortunately have risk of developing cancer before the age of 50. There are other cancers
associated with this syndrome and so that would be the second one. There are others
such as juvenile polyposis, Peutz-Jeghers. There are more recently identified MUTYH gene which is mutated, that's another family
syndrome.
So these are specific syndromes that are associated with cancers that should then be followed
in other family members in future patients and screening should be employed in these
individuals. This is important to distinguish from the sporadic or the more everyday risk
that one sees in families and this involves for example a family member who unfortunately
developed colon cancer before the age of 60, first degree relative that does raise an individual's
risk. Similarly in second degree relatives or grandparents, cousins, if two individuals
develop colon cancer, that also might raise a given patient's risk. So yes, there are
hereditary syndromes. There are very specific ones, but there is also more common average
risk that is associated with family members that somehow or at sometime develop colon
cancer.