At City of Hope, we have an expert multidisciplinary care team for individuals and their family members with Lynch syndrome, familial adenomatous polyposis, and other colon cancer-causing syndromes. In some families Lynch syndrome may develop into colorectal, ovarian, stomach, and other cancers. Familial adenomatous polyposis may lead to colorectal, thyroid, and brain tumors — among other cancers. Our team offers comprehensive hereditary syndrome care, including:
Precision cancer screening
My job boils down to two things: Can we find the cause of the cancer predisposition and, if so, how can we keep an individual free from developing cancer once we’ve identified genes linked to it? If a genetic change is found early on, the potential exists to reverse destiny." Thomas Slavin, M.D., clinical geneticist
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Colon and rectal cancer occurs more commonly in some families, and we have identified genetic mutations that significantly increase the risk in other families." Steve Sentovich, M.D., colorectal surgeon
Most cancer develops sporadically — when a genetic problem occurs within a cell and causes it to start to grow and spread uncontrollably. For a smaller percentage of cancers, genetics is what drives the development and growth of cancer cells.
Genetic problems (mutations) passed down within certain families, that later develop into cancer, are called hereditary. Approximately 5-10% of colorectal cancers are strongly associated with hereditary risks, while another 20% or more are not as well-defined, but are likely inherited — or are a combination of genetics interacting with environmental factors like poor dietary habits.
Some factors suggesting a family may have a hereditary risk for cancer include:
- Close family members (parents, siblings) diagnosed with the same cancer
- Several family members and/or generations diagnosed with more than one cancer
- Cancer that is diagnosed before age 50
Hereditary colorectal cancer types
There are two main types of hereditary colorectal cancer:
- Lynch syndrome, also called hereditary nonpolyposis colorectal cancer, is usually found in families with multiple generations of people diagnosed with colon cancers at age 50 or younger. People found to have Lynch have a 50-80% lifetime risk of developing colorectal cancer; tend to develop it at younger ages; and females with the mutation have a 40-60% risk of developing endometrial cancer.
- Familial adenomatous polyposis (FAP) causes hundreds, sometimes thousands, of polyps to develop in the colon and tends to develop in young people. If not caught early, the risk of colon cancer developing by age 40 is nearly 100%.
Most hereditary colorectal cancers are associated with Lynch syndrome; and Lynch syndrome can lead to other cancers, including stomach (gastric), endometrial (uterine), ovarian, small intestine, liver, gallbladder, bile duct, kidney, bladder, brain and skin.
Hereditary genetic testing vs. tumor testing
Hereditary genetic testing looks at mutations in all cells of the body — mutations that can be passed from generation to generation. Tumor testing looks for genetic anomalies that are newly acquired in the tumor, rather than inherited; new mutations that are causing cells to grow in an uncontrolled manner.
At City of Hope, we have the ability to test for changes in the tumor, as well as changes in an individual's genes that may be associated with a hereditary cancer syndrome.
Anatomic and Clinical Pathology
Colon and Rectal Surgery