ASGE Annual GI Advanced Practice Provider Course (On-demand) (Day One) | March 2026-SESSION B: Hereditary Polyposis Syndromes

Video Transcription

Video Summary

The talk reviews hereditary polyposis syndromes and when to refer patients for genetic testing or a high-risk cancer clinic. The key referral trigger is polyp burden: more than 10–20 cumulative adenomas (often “10” as a practical threshold) should prompt evaluation for a polyposis syndrome. Updated post-polypectomy surveillance intervals are summarized: 10 years for normal exams, 7–10 years for 1–2 small adenomas, 3–5 years for multiple small adenomas, and 3 years for high-risk pathology (villous features, high-grade dysplasia, traditional serrated adenoma) or higher polyp counts. Major syndromes covered include FAP/attenuated FAP (APC; near-100% CRC risk in classic; extracolonic cancers), MUTYH-associated polyposis (autosomal recessive), Lynch syndrome (mismatch repair genes; Amsterdam criteria; extracolonic cancers), sessile serrated polyposis (WHO criteria; difficult-to-see lesions), and hamartomatous syndromes (Peutz-Jeghers, juvenile polyposis, PTEN-related). The speaker highlights the alarming rise in early-onset colorectal cancer and notes hereditary causes may account for up to 35%, emphasizing careful personal and family history and review of prior pathology.

Asset Subtitle

Vijaya Rao, MD, FASGE

Keywords

hereditary polyposis syndromes

genetic testing referral criteria

adenoma polyp burden threshold

post-polypectomy surveillance intervals

Lynch syndrome mismatch repair genes

familial adenomatous polyposis APC MUTYH