What should you know about FAP colon cancer screening?

Familial adenomatous polyposis, or FAP, is an inherited condition in which many adenomatous polyps can form in the colon and rectum. Polyps may be present before symptoms appear, so screening is planned around family history and genetic advice rather than waiting for bleeding or pain. A colonoscopy lets a specialist inspect the bowel lining and remove or sample concerning tissue. Results help the team decide how often to repeat checks and whether surgery should be discussed.

Screening may also involve reviewing the stomach or other areas, depending on your inherited condition and specialist plan. If bowel cancer is found, further tests may guide treatment, including genomic tumour profiling. Advanced disease can sometimes involve the liver, which is assessed separately.

Ask for a coordinated appointment with a gastroenterology or hereditary-cancer team. Bring previous colonoscopy reports, pathology results, and details of relatives with FAP or bowel cancer. Follow the bowel-preparation instructions closely; the examination depends on a clear view. Tell the team about medicines, bleeding disorders, pregnancy, and any difficulty with the preparation.

Discuss genetic counselling for close relatives when appropriate. Your plan may change if polyps become numerous, difficult to remove, or show advanced changes. Possible treatments include bowel resection, radiotherapy in selected situations, or stoma surgery; these decisions depend on findings and are not determined by screening alone.

Contact your clinical team promptly for blood in the stool, black stools, persistent change in bowel habit, worsening abdominal pain, repeated vomiting, unexplained tiredness, or unintentional weight loss. Seek urgent help for heavy bleeding, fainting, severe abdominal swelling, or sudden intense pain. These symptoms need assessment whether or not your next screening appointment is due.

Ask when your next colonoscopy is due, which bowel areas will be examined, how polyps will be removed, and what result would change your schedule. You can also ask whether relatives should have genetic assessment and when surgery becomes a reasonable option.