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Hereditary Colon Cancer
Andrea Wang-Gillam, MD
Dr. Andrea Wang-Gillam treats patients at

Center for Advanced Medicine
Siteman Cancer Center
4921 Parkview Place, 7th Floor, Suite A
St. Louis, MO 63110

Phone: 314-747-1171     314-362-5740
Fax: 314-362-7086

Medical Building Two
Barnes-Jewish West County Hospital
10 Barnes West Drive
Creve Coeur, MO 63141

Phone: 314-747-1171     Fax: 314-362-3646
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Question: My father died of colon cancer at the age of 70, and my brother has been diagnosed with it at the age of 45. Is it hereditary and how do I find out if I am especially at risk?

Answer: Colorectal cancer is a common disease in the United States with an estimated 6% lifetime risk for the average American. A colonoscopy is the best way to screen for colorectal cancer and it is recommended for the general population every ten years, beginning at the age of 50.

Although the majority of colorectal cancer occurs sporadically, about 20% of colorectal cases are found within family clusters. It is known that people who have a certain genetic abnormality are prone to have colorectal cancer at a younger age, as the genetic abnormality is passed on to the next generation, and within these families, a higher incidence of colorectal cancer is seen.

Among the hereditary conditions, hereditary nonpolyposis colorectal cancer (HNPCC), also called Lynch syndrome, is the most common, and it accounts for one to five percent of all colon cancer.

Your risk for colorectal cancer is higher than the average person because you have a strong family history of colon cancer, especially with your brother diagnosed before the age of 50. It is possible that your family carries a particular genetic abnormality that contributes to the early onset of colon cancer. Currently, there are tests available to detect these genetic abnormalities.
 
Your brother should be the one that undergoes evaluation for the inheritable forms of colorectal cancer, such as Lynch syndrome. In addition, you should see a genetic counselor to determine your risk and possibility of genetic testing once your brother’s information becomes available.

The time and the frequency of colonoscopy screening should be discussed with your genetic counselor as monitoring is much more rigorous in people with genetic risk factors.

Meanwhile, you should consider eating a diet high in fruits and vegetables and increase physical activity. These lifestyle choices may protect you from colorectal cancer. You can talk to your doctor about the use of aspirin or nonsteroidal anti-inflammatory drugs (NSAID) for colorectal cancer prevention as well.
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Copyright 2013 Washington University School of Medicine