Personalised endoscopic surveillance and intervention in FAP
Research type
Research Study
Full title
A personalised surveillance and intervention protocol for patients with familial adenomatous polyposis: an international multi-centre prospective study
IRAS ID
317657
Contact name
Andrew Latchford
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Familial adenomatous polyposis (FAP) is a rare inherited condition, in which hundreds to thousands of pre-cancerous polyps develop in the bowel, requiring some form of surgery to prevent colorectal cancer.
After such surgery, patients will still require life-long surveillance endoscopy to monitor and treat new polyps which form.
National and European guidelines recommend endoscopic monitoring, with the interval personalised according to an individuals polyp burden. There are no agreed criteria
as to which polyps to remove nor criteria to help decide the interval between monitoring procedures. consider resecting polyps, although often a threshold of 3-5mm is used. Therefore how tailor an individuals monitoring endoscopy is subjective and variable.
In addition these patients require lifelong monitoring due to the risk of developing pre-cancerous polyps in the duodenum and stomach. Again the frequency of monitoring endoscopy is personalised according to the size and number of polyps in the stomach and duodenum; again there are no robust agreed standard for how to combine these findings to determine how often endoscopy should be performed and it is not agreed at what size polyps in the stomach should be removed.
A group of European experts constructed a more defined protocol for the prospective management of these patients. It gives criteria as to when to remove polyps and also how to determine the frequency of endoscopy monitoring. The suggestions all fall within current national and international guidelines, so effectively they do not alter patient care. It does however give standardised care and a means to then assess the effectiveness of this strategy.
Because of the rarity of the condition a multi-center approach is required in order to be able to effectively assess important outcomes.REC name
Wales REC 4
REC reference
24/WA/0356
Date of REC Opinion
20 Jan 2025
REC opinion
Further Information Favourable Opinion