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ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes
Open accessAbstract
This guideline presents recommendations for the management of patients with hereditary gastrointestinal cancer syndromes. The initial assessment is the collection of a family history of cancers and premalignant gastrointestinal conditions and should provide enough information to develop a preliminary determination of the risk of a familial predisposition to cancer. Age at diagnosis and lineage (maternal and/or paternal) should be documented for all diagnoses, especially in first- and second-degree relatives. When indicated, genetic testing for a germline mutation should be done on the most informative candidate(s) identified through the family history evaluation and/or tumor analysis to confirm a diagnosis and allow for predictive testing of at-risk relatives. Genetic testing should be conducted in the context of pre- and post-test genetic counseling to ensure the patient's informed decision making. Patients who meet clinical criteria for a syndrome as well as those with identified pathogenic germline mutations should receive appropriate surveillance measures in order to minimize their overall risk of developing syndrome-specific cancers. This guideline specifically discusses genetic testing and management of Lynch syndrome, familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome, juvenile polyposis syndrome, Cowden syndrome, serrated (hyperplastic) polyposis syndrome, hereditary pancreatic cancer, and hereditary gastric cancer.
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“Pancreas surveillance has been recommended for individuals estimated to be at high risk of developing PDAC (5% or higher estimated lifetime risk).5-8”
From The Multicenter Cancer of Pancreas Screening Study: Impact on Stage and Survival (2022) · cites this paper as [8]
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Metadata
- Authors
- Syngal, S., Brand, R. E., Church, J. M., Giardiello, F. M., Hampel, H. L., & Burt, R. W.
- Affiliations
- Brigham and Women's Hospital (US)
- University of Pittsburgh Medical Center (US)
- Cleveland Clinic (US)
- Johns Hopkins University (US)
- The Ohio State University (US)
- Huntsman Cancer Institute (US)
- Corresponding author
- Syngal, Sapna
- Venue
- American Journal of Gastroenterology
- Published
- 2015-02
- Volume
- 110
- Issue
- 2
- Pages
- 223-262
- ISSN
- 0002-9270 (ISSN-L)
- PMC
- PMC4695986
- OpenAlex
- W2162077547
- Cited by
- 1,662
- References
- 326
- Citations by year
- 2026: 110 · 2025: 118 · 2024: 155 · 2023: 137 · 2022: 172 · 2021: 195 · 2020: 186 · 2019: 160 · 2018: 135 · 2017: 139 · 2016: 110 · 2015: 43
- FWCI
- 113.05
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Gastroenterology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (K24-11311)
- National Cancer Institute (P30CA006973)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Keywords
- germline genetic testing, Lynch syndrome, familial adenomatous polyposis, attenuated familial adenomatous polyposis, MUTYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis syndrome, Cowden syndrome, serrated polyposis syndrome, hereditary pancreatic cancer, hereditary gastric cancer, cancer surveillance, genetic counseling, family history assessment, cancer susceptibility
- MeSH terms
- Colorectal Neoplasms, Hereditary Nonpolyposis, Gastrointestinal Neoplasms, Genetic Testing, Hamartoma Syndrome, Multiple, Humans, Neoplastic Syndromes, Hereditary, Peutz-Jeghers Syndrome, Adenomatous Polyposis Coli, Disease Management, Intestinal Polyposis
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