Abstract
Hereditary Non-Polyposis Colorectal Cancer （HNPCC）is a very important clinical entity in the respect of several clinical features, such as its relatively high incidence, the occurrence of multiple cancers in relatively young age, and the requirement for continuous long-term surveillance not only in the patient but also for family members. However, several problems exist in the clinical aspect of the management of HNPCC. 1, The rate of accurate diagnosis of this disease in the city hospital is very low. 2, As for the diagnostic criteria, the Japanese clinical criteria is not an efficient screening and the Amsterdam criteria also has several problems. 3, Neither analysis of microsatellite instability as a supportive diagnostic tool nor genetic testing as a final diagnosis is covered by medical insurance. 4, A useful and practical surveillance protocol has yet to be established. 5, There are very few numbers of institutes and specialists that deal with hereditary diseases in Japan, and it is necessary to construct a total social system to support advance in genetic medicine.
