Cancer screening guidelines and prevention factors for high-risk patients with a family history of colorectal cancer

Family history of colorectal cancer or of adenomas may confer significant risk of colorectal cancer. Ideally, diagnosis of an inherited syndrome such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC) enables a molecular biology-driven approach to screening and management. When no hereditary syndrome can be established, clinicians must rely on empiric risk estimates and offer screening accordingly. Detailed rationale and guidelines for use of syndrome characteristics including genetic testing, counseling, and selection of surveillance tools are discussed.