A systematic review found that registration, surveillance and colectomy have a consistent and significant reduction in incidence and CRC related mortality.r
Expert opinion is that children at risk for classic FAP are screened every 1 to 2 years by flexible sigmoidoscopy or colonoscopy, beginning at 10 to 12 years of age.rr
Those initially screened at an older age should probably have colonoscopy for the first examination.r If surgery is delayed longer than a year after polyps emerge, annual colonoscopy should be used for surveillance.
In AFAP the emergence of adenomas and cancer is delayed 10 to 20 years compared with classical FAP. People with AFAP have fewer adenomas than those with classical FAP, although polyp number is variable within kindreds. As polyps have a more proximal colonic preponderance colonoscopy should be used for screening (not sigmoidoscopy), usually starting from late teens and repeated every 1 to 2 years depending on polyp burden.rr
The upper GI surveillance protocol is based on published literature and expert opinion.r