What is the treatment for familial adenomatous polyposis (FAP)?

Familial adenomatous polyposis (FAP) is a hereditary condition characterized by the development of multiple polyps in the lining of the colon and rectum, which, if left untreated, have a near 100% risk of progressing to colorectal cancer. The primary treatment for FAP is prophylactic colectomy, which involves the surgical removal of the colon before cancer can develop. This intervention dramatically reduces the risk of cancer associated with the condition.

Given that patients with FAP are at high risk for colorectal cancer due to the polyps, regular colonoscopies, while important for monitoring, do not provide a definitive solution or prevention against cancer development in this case. Chemotherapy is not a treatment for FAP itself but is utilized as a method to treat cancer. Watchful waiting is inappropriate for FAP, as this would neglect the urgent need to prevent cancer formation due to the high polyp load.

Thus, prophylactic colectomy is the cornerstone of managing familial adenomatous polyposis to significantly mitigate the risk of colorectal cancer. This proactive approach reflects the critical nature of early intervention in genetic conditions like FAP.