Durham, N.C. — Everyone is at risk of colorectal cancer. That is why doctors recommend people start colon cancer screening by age 50. However, a family history of colon cancer means people should think about getting a screening earlier.
Nearly 30 years ago, Jane Elliott's father was still a young man when he died from Familial Adenomatous Polyposis (FAP) colorectal cancer. FAP is hereditary, so Elliott was determined to prevent herself from developing it.
So she told herself, “when I turn 40, I will have a colonoscopy – and that was at age 19,” Elliott said.
Eight years ago. Elliott got a colonoscopy. She was 40 years old and learned she had non-cancerous FAP colorectal polyps.
The doctor told me, "you have a 100 percent chance of developing colon cancer if you don't have surgery,” Elliott said.
“With FAP, what you actually have is a complete carpeting of your colon and rectum," said Dr. Christopher Mantyh, chief of gastrointestinal and colorectal surgery at Duke University Hospital said. "You will literally have hundreds or even thousands of polyps."
Mantyh says most people with a significant family history of colorectal cancer should start screening by age 40. But with a FAP family history, screening should start earlier, Mantyh said. The cancer can be detected with genetic testing.
“At the time, we usually recommend a prophylactic colectomy – where we take out the colon,” Mantyh said.
Elliott had a colon resection before cancer developed, and later discovered pre-cancerous cysts on her ovaries. She then had an early tumor removed from her pancreas.
“With FAP, everything in the abdominal area is fair game,” Elliott said.
FAP is rare and accounts for only 5 percent of colorectal cancers.