National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Attenuated familial adenomatous polyposis

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I had one colonoscopy with 24 adenomatous polyps and one polyp had cancer in it. I have since been diagnosed with attenuated familial adenomatous polyposis (AFAP). I am wondering when it is recommended to remove the colon.
In general, colectomy (removal of all or part of the colon) may be considered in individuals with attenuated familial adenomatous polyposis (AFAP) when the number of polyps is too many to remove during colonoscopy.[1][2]  Management guidelines for AFAP also suggest that colectomy may be appropriate when 21 or more polyps are identified during one colonoscopy, if any polyp is greater than one centimeter in size, or if any polyp is found to contain cells that appear cancerous.  Colectomy may also be considered if an individual with AFAP cannot or will not undergo regular screening.[2]

The decision to have a colectomy is a very personal one and should be discussed with a physician who is familiar with AFAP; any decision should be based on physical findings, genetic testing results, and personal considerations.[2]
Last updated: 4/6/2015

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  1. Kory W Jasperson, MS and Randall W Burt, MD. APC-Associated Polyposis Conditions. GeneReviews. March 27, 2014; http://www.ncbi.nlm.nih.gov/books/NBK1345/.
  2. National Comprehensive Cancer Network. Genetic/Familial High-Risk Assessment: Colorectal. NCCN Clinical Practice Guidelines in Oncology. 2014; http://www.nccn.org/professionals/physician_gls/pdf/genetics_colon.pdf. Accessed 4/6/2015.