Current Initiatives in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) for the Establishment of Clinical Practice Guidelines for Familial Adenomatous Polyposis (FAP)

Abstract

Japanese Society for Cancer of the Colon and Rectum (JSCCR) has issued the JSCCR Guidelines 2012 for the Clinical Practice of Hereditary Colorectal Cancer for which the JSCCR Familial Colorectal Cancer Committee took the initiative in the development with the cooperation of the Japanese Society for Familial Tumors. In 2012, familial adenomatous polyposis (FAP) working group established in the JSCCR Familial Colorectal Cancer Committee has launched a retrospective multicenter cohort study. This study was designed to clarify the characteristics of the disease in the Japanese population and to disclose an actual status of the treatment of FAP in Japan which were expected to be rationales for the revision of the guidelines. This study involved 23 Japanese special institutions for colorectal diseases and clinical data were accumulated comprehensively in 303 FAP patients who underwent first surgical interventions between 2000 and 2012. These data are currently being analyzed in terms of following seven points: i.e., (1) time trend of surgical treatment; (2) risk of cancer development; (3) surgical procedure and postoperative complications; (4) risk factors of FAP-associated extra-colonic tumors and their treatment; (5) morphological analysis of colonic tumors; (6) clinical features of attenuated FAP; (7) influence of hospital characteristics on FAP treatment. Further initiatives by JSCCR should include some prospective cohort studies focusing on specific clinical questions to established EBM-based clinical practice for FAP patients in Japan.