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Changing causes of mortality in patients with familial adenomatous polyposis


Widespread use of prophylactic colectomy has resulted in a reduction in the incidence of colorectal cancer in familial adenomatous polyposis (FAP) patients. A retrospective chart review of families registered at the Steve Atanas Stavro Familial Gastrointestinal Cancer Registry in Toronto was performed to determine whether the decrease in the number of patients developing colorectal cancer implies that causes of mortality in FAP patients are shifting to that of extracolonic manifestations of FAP. Information was available on 140 deaths within 158 families and among 461 individuals with FAP. When stratified by decade, from the 1930s to the 1990s, the ratio of deaths caused by extracolonic manifestations of FAP compared with deaths caused by colorectal cancer was noted to have risen. Even though most deaths in FAP patients are still from colorectal cancer, it appears that screening policies and prophylactic colectomy have resulted in a reduction in the number of FAP patients who develop colorectal cancer. Thus, in recent decades, a greater percentage of deaths in FAP patients appears to be attributable to extracolonic manifestations of the disease.

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Corresponding author

Correspondence to Steven Gallinger M.D..

Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, Montreal, Quebec, Canada, May 7 to 12, 1995, and at the Clinical Research Society of Toronto, Toronto, Ontario, Canada, April 29, 1995.

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Belchetz, L.A., Berk, T., Bapat, B.V. et al. Changing causes of mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 39, 384–387 (1996).

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Key words

  • Familial adenomatous polyposis
  • Colorectal carcinoma
  • Desmoid tumors
  • Periampullary tumors